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 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 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. 

scholarly journals The treatment of patients with chronic rhinosinusitis in the conditions of sanatorium and preventive measures

2020 ◽  
Vol 19 (2) ◽  
pp. 57-63
Author(s):  
S. I. Pshenichnyi ◽  
◽  
R. K. Tulebaev ◽  
T. M. Azhenov ◽  
◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Mucosa ◽  
Paranasal Sinuses ◽  
Comparison Group ◽  
Treatment Method ◽  
Functional Disorders ◽  
Acid Base Balance ◽  
Natural Factors ◽  
Base Balance ◽  
Chronic Rhino Sinusitis

The objective of the research is to study of clinical and functional disorders of the nasal mucosa and paranasal sinuses of patients with chronic rhino sinusitis, as well as to make the choice of the optimal treatment method in a sanatorium using natural factors. A survey of 145 patients (94 men and 51 women) with chronic rhinosinusitis at the age of 18 to 65 years was conducted. Of these, male accounted for 64.8%, female – 35.2%. In patients with pathology of the paranasal sinuses, functional disorders of the nasal mucosa and paranasal sinuses were revealed. Particularly, violations of mucociliary clearance, acid-base balance of the nasal mucosa, and a decrease in nasal patency according to the data of active anterior rhinomanometry were defined. The use of natural factors as a treatment: inhalation of natural mineral water Maibalyk and mud applications on the paranasal sinus area significantly improved the course of way of chronic rhinosinusitis and led to normalization of the functional parameters of the nasal mucosa, in contrast to the comparison group (60 people). The comparison group did not use with Maibalyk natural water inhalations and mud applications from Lake Maybalyk, but used only ordinary alkaline inhalations.

scholarly journals Substance P and Hemokinin 1 in Nasal Lavage Fluid of Patients with Chronic Sinusitis and Nasal Polyposis

OTO Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 2473974X1987507
Author(s):  
Ashley Lonergan ◽  
Theoharis Theoharides ◽  
Eirini Tsilioni ◽  
Elie Rebeiz
Keyword(s):  
Substance P ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Medical Center ◽  
Disease Process ◽  
Lavage Fluid ◽  
Nasal Lavage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Nasal Lavage Fluid

This pilot study was undertaken to isolate and quantify substance P (SP) and hemokinin 1 (HK-1) in the nasal lavage fluid of patients with chronic rhinosinusitis with nasal polyps to better elucidate the pathophysiology underlying this inflammatory process, which remains poorly understood. Mucus samples were collected from this introductory cohort of 10 patients diagnosed with chronic rhinosinusitis with nasal polyps at Tufts Medical Center (Boston, Massachusetts). Relative levels of SP and HK-1 were measured with enzyme-linked immunosorbent assay methods. Both inflammatory neuropeptides were found in detectable and comparable amounts in patient samples and in concentrations up to 100-fold those established in past literature. The presence of SP and HK-1 necessitates further investigation into their role in nasal polyposis and the potentiation of the chronic inflammation inherent to chronic rhinosinusitis. Downregulating these peptides could therefore provide novel treatment targets to manage this disease process.

Osteomeatal Complex Obstruction is not Associated with Adjacent Sinus Disease in Chronic Rhinosinusitis with Polyps

2011 ◽  
Vol 25 (6) ◽  
pp. 401-403 ◽  
Author(s):  
Randy M. Leung ◽  
Robert C. Kern ◽  
David B. Conley ◽  
Bruce K. Tan ◽  
Rakesh K. Chandra
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Disease Process ◽  
Subsequent Development ◽  
Ct Scans ◽  
Osteomeatal Complex ◽  
Maximal Medical Therapy ◽  
Previous Pilot Study

Background It is universally accepted that osteomeatal complex (OMC) disease is linked to the subsequent development of chronic rhinosinusitis without nasal polyps (CRSsNPs) via postobstructive mechanisms. The role of OMC obstruction in the pathogenesis of CRSwNPs is less clear. This study was designed to identify if there is an association between OMC obstruction and inflammation of the adjacent sinuses, when patients are stratified by polyp status. This is a follow-up and expanded series of a previous pilot study from our group. Method CT scans of 144 patients with CRSsNPs and 123 patients with CRS with nasal polyps (CRSwNPs) were evaluated for each sinus and OMC. Patients had no previous surgeries for NPs. CT scans were obtained after a trial of maximal medical therapy. Results Increasing OMC involvement was associated with increasing Lund-Mackay score for both CRSsNPs and CRSwNPs. In CRSsNP patients, OMC status significantly correlated with adjacent sinus status (p < 0.0001). Meanwhile in CRSwNPs, OMC status does not correlate with adjacent sinus status (p = 0.328). Conclusion OMC obstruction in the setting of CRSwNP may be a barometer of the overall disease process, but in this scenario, paranasal sinus inflammation can not be classified as a postobstructive phenomenon. These findings question the role of minimally invasive procedures in the management of CRSwNPs.

scholarly journals A clinicopathological study of the lesions of paranasal sinuses causing proptosis

2020 ◽  
Vol 6 (7) ◽  
pp. 1238
Author(s):  
Vineeth Abraham Anchery ◽  
Viswanathan Kavathur
Keyword(s):  
Paranasal Sinuses ◽  
Disease Process ◽  
Underlying Disease ◽  
Fungal Sinusitis ◽  
Nasal Sinus ◽  
Sinus Disease ◽  
Duration Of Illness ◽  
Male Preponderance ◽  
Malignant Lesions ◽  
Benign Tumours

<p class="abstract"><strong>Background:</strong> The orbit and its contents lie in close proximity to the paranasal sinuses. The aim of the study was to analyse the lesions of paranasal sinuses causing proptosis.</p><p class="abstract"><strong>Methods:</strong> All patients with proptosis secondary to paranasal sinus disease were taken up for a systematic otolaryngological and ophthalmological clinical evaluation and investigation using a standard proforma. Incidence of various disease of paranasal sinuses causing proptosis, age and sex distribution, incidence of different symptoms and signs and its association with proptosis were estimated. The reversible and irreversible nature of the proptosis in relation to the degree of proptosis and the histopathological nature of the disease were studied.  </p><p class="abstract"><strong>Results:</strong> Malignant diseases were found to be the commonest lesion that caused proptosis. Squamous cell carcinoma was the most common histopathological type. Invasive fungal sinusitis among inflammatory and inverted papilloma among benign tumours were the commonest lesions that cause proptosis. Male preponderance was seen in the inflammatory and malignant lesions and the commonest symptoms were headache and nasal obstruction. Malignancies caused faster proptosis than benign and inflammatory lesions. Analysis of X-ray and computed tomography (CT) findings were also done.</p><p class="abstract"><strong>Conclusions:</strong> Malignant lesions are the most common para nasal sinus disease that cause proptosis. Duration of illness and degree of proptosis varied with the underlying disease process. With inflammatory proptosis some underlying sinus pathology in addition to the sinusitis is found in all cases. CT is a better modality to identify underlying pathology.</p>

scholarly journals Pediatric Endoscopic Sinus Surgery in a Tertiary Government Hospital: Patient Profile and Surgical Indications

2009 ◽  
Vol 24 (1) ◽  
pp. 13-17
Author(s):  
Michael Joseph C. David ◽  
Gil M. Vicente ◽  
Antonio H. Chua
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyp ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Nasal Polyposis ◽  
Sinus Surgery ◽  
Government Hospital ◽  
Female Ratio ◽  
Sinus Disease ◽  
The Mean

Objective: To describe the clinical and demographic profile of patients who underwent pediatric Endoscopic Sinus Surgery (ESS), and the indications for which the procedure was performed. Methods: Design: Cross-sectional Study Setting: Tertiary Government Hospital Subjects: Using the medical record registry, all patients below 18 years of age who underwent ESS under the Department of Otorhinolaryngology – Head and Neck Surgery of a tertiary government hospital in Metro Manila between December 31, 1999 and January 1, 2008 were reviewed. The age, sex, clinical presentation, and indications for doing ESS, and extent of surgery done were described. The Lund MacKay Grading for nasal polyposis and Scoring for sinusitis were also applied and cross-referenced. Results: Twenty-seven children aged 7 to 17 years underwent ESS. The mean age was 12.9 years, with most (15 patients) belonging to the adolescent age group (13-17 years). Male to female ratio was 1.45:1. The mean interval from onset of symptoms to the first outpatient consultation was 1.5 years; the most common presenting symptoms were nasal obstruction (85.2%) and discharge (59.3%). All of the patients who underwent pediatric ESS had chronic rhinosinusitis: either with nasal polyposis (85.2%), an antrochoanal polyp (11.1%), or both (3.7%). The Lund Mackay Grading for nasal polyps and sinusitis scores were cross-referenced: patients with larger, grade III nasal polyps tended to have more extensive sinus disease than those with grade II polyps. On their first consultation, the patients tended to present with extensive nasal polyp and sinus disease, indicating the need for surgery. All patients with CRS and nasal polyposis underwent polypectomy with ethmoidectomy, uncinectomy and maxillary antrostomy, with additional frontal sinusotomy for a 17 year old male and a 17 year old female, both with grade 3 polyposis. The three patients who had antrochoanal polyps underwent polypectomy with uncinectomy and maxillary antrostomy. There were no operative complications such as cerebrospinal fluid leak and orbital injury reported. Conclusion: Most of the patients who underwent pediatric ESS were older children who were brought for consultation with long-standing, extensive nasal polyp and sinus disease or with antrochoanal polyps, necessitating surgical management. Patients with larger polyps tended to have more extensive sinus disease. They all underwent conservative surgery, with extent of the procedure limited to the extent of the disease present. Efforts to raise public awareness about chronic rhinosinusitis and nasal polyposis in children may result in seeing such cases at an earlier, conservatively treatable stage   Keywords: Pediatric Endoscopic Sinus Surgery, Nasal Polyposis in Children

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 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.

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