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 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.

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.

The nose and sinuses

2009 ◽  
pp. 159-184
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Chronic Sinusitis ◽  
Structure And Function ◽  
Acute Sinusitis ◽  
And Function ◽  
Nose And Sinuses

Structure and function of the nose 160 Rhinitis 164 Types of rhinitis 165 Medical treatment of rhinitis 166 Surgical treatment of rhinitis 168 Sinusitis 169 Acute sinusitis 170 Recurrent acute sinusitis 171 Chronic sinusitis 172 Surgery for chronic rhinosinusitis 174 Complications of sinusitis 176 Nasal polyps ...

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.

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 Clinical Consensus Statement: Ankyloglossia in Children

2020 ◽  
Vol 162 (5) ◽  
pp. 597-611 ◽  
Author(s):  
Anna H. Messner ◽  
Jonathan Walsh ◽  
Richard M. Rosenfeld ◽  
Seth R. Schwartz ◽  
Stacey L. Ishman ◽  
...  
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Delphi Method ◽  
Expert Panel ◽  
Target Population ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Older Children ◽  
Modified Delphi ◽  
Consensus Statements

Objective To identify and seek consensus on issues and controversies related to ankyloglossia and upper lip tie in children by using established methodology for American Academy of Otolaryngology–Head and Neck Surgery clinical consensus statements. Methods An expert panel of pediatric otolaryngologists was assembled with nominated representatives of otolaryngology organizations. The target population was children aged 0 to 18 years, including breastfeeding infants. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus, per established methodology published by the American Academy of Otolaryngology–Head and Neck Surgery. Results After 3 iterative Delphi method surveys of 89 total statements, 41 met the predefined criteria for consensus, 17 were near consensus, and 28 did not reach consensus. The clinical statements were grouped into several categories for the purposes of presentation and discussion: ankyloglossia (general), buccal tie, ankyloglossia and sleep apnea, ankyloglossia and breastfeeding, frenotomy indications and informed consent, frenotomy procedure, ankyloglossia in older children, and maxillary labial frenulum. Conclusion This expert panel reached consensus on several statements that clarify the diagnosis, management, and treatment of ankyloglossia in children 0 to 18 years of age. Lack of consensus on other statements likely reflects knowledge gaps and lack of evidence regarding the diagnosis, management, and treatment of ankyloglossia. Expert panel consensus may provide helpful information for otolaryngologists treating patients with ankyloglossia.

scholarly journals Clinical Presentations of Patients with Chronic Rhinosinusitis

2021 ◽  
pp. 257-263
Author(s):  
Ahmad Mujahed Abdulqader Mousa ◽  
Zadorozhna Anna ◽  
Dieieva Julia ◽  
Tereshchenko Zhanna ◽  
Konovalov Serhii
Keyword(s):  
Infectious Disease ◽  
Chronic Rhinosinusitis ◽  
Clinical Features ◽  
Paranasal Sinuses ◽  
Nasal Congestion ◽  
Nasal Discharge ◽  
Impaired Ability ◽  
Clinical Presentations ◽  
The Face ◽  
Anterior Posterior

Purpose of Review: Chronic rhinosinusitis (CRS) is denoted as the symptomatic inflammations of sin nasal mucosa persists for ≥12 weeks. The purpose of this study was to review the recent literatures for digging out a clear concept on the clinical presentations of patients with chronic rhinosinusitis and assess the potentialities of the features. Recent Findings: According to the findings, descriptions and discussions of several recent studies it was observed that, a package of clinical features and presentations are associated with chronic rhinosinusitis. Some are major and some are minor potentials. The frequencies and severities of symptoms and features are directly dependent on the duration of that disease. Summary: Basically, rhinosinusitis or CRS is an inflammatory and infectious disease which affects the nasal cavities as well as the paranasal sinuses of patients. Rhinosinusitis with polyps is more common in male than that in female. There are many possible clinical features of CRS. But as per the frequencies, duration and effects nasal congestion, nasal discharge (Anterior/posterior nasal drip), pain/pressure on the face, impaired ability to smell (Hyposmia/anosmia), dizziness, fever and cough are the most common clinical features of chronic rhinosinusitis.

Experience of the center for diagnosis and treatment of chronic rhinosinusitis with nasal polyps

2020 ◽  
Vol 19 (6) ◽  
pp. 8-15
Author(s):  
V. I. Egorov ◽  
◽  
O. M. Kurbacheva ◽  
E. L. Savlevich ◽  
K. N. Shachnev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Study Data ◽  
Diagnosis And Treatment ◽  
Dynamic Monitoring ◽  
Surgical Interventions ◽  
Regional Center

Polypous rhinosinusitis (PRS) ranks as one of the most important chronic inflammatory ENT diseases that significantly impair the quality of life. Today, it is known that chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial heterogeneous disease characterized by chronic inflammation of the mucosa of the nasal cavity and paranasal sinuses, leading to the growth of polyps. The interrelation of CRSwNP, atopy and bronchial asthma (BA), their pathogenetic mechanisms, as well as the effect on the severity of the course and the frequency of each other’s relapses, are the subject of study. Data on the role of allergy in CRSwNP are controversial, while the relationship between PRS and BA is not in doubt. Patients suffering from CRSwNP and BA and / or allergic rhinitis (AR) require dynamic monitoring and regular correction of treatment not only by an otorhinolaryngologist, but also by an allergist-immunologist. To this end, since 2016, in Vladimirsky Moscow Regional Research Clinical Institute the Moscow Regional Center for Diagnosis and Treatment of Polypous Rhinosinusitis and Allergic Rhinitis was established, which monitored and treated patients with ARS and comorbid diseases from various medical institutions of the Moscow region. By using a multidisciplinary approach during our work from 2016 to 2020, we managed to achieve a stable remission in most patients, significantly improve their quality of life and reduce the number of surgical interventions.

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