DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20200618

Relationship between postoperative recurrence rate and eosinophil density of nasal polyp: a record based retrospective study

Kholood S. Assiri, Abdullah Al-shahrani, Abdullah H. Alwadai, Mohammad S. Al Ahmari

Abstract


Background: Nasal polyposis is one of the chronic sever airway diseases. It is known as a non-neoplastic inflammatory process of nasal mucosa that eventually leads to the outgrowth of abnormal masses inside the mucosa of nasal cavity and paranasal sinuses. Eosinophils and nasal polyps are believed to affect the surgical outcome of chronic rhinosinusitis (CRS). This study was conducted to determine relationship between postoperative recurrent nasal polyp rate and types of histopathology of nasal polyp.

Methods: A retrospective study of 121 patients at Khamis Mushayt General Hospital (Aseer region, Saudi Arabia) from 2012 to 2017. All diagnosed and treated for nasal polyposis with different histopathological types. we collect all the recurrent cases with the same histopathological result.  

Results: The study included 121 patients with polyps whose ages ranged from 18 to 77 years old. 58% were males and 42% were females.  it was noticed that 33.9% of edematous types of polyps with Eosinophilic infiltration were recurrent compared to 25% of other types among patients below the age of 30 years with no statistical significance. At patients above 30 years, the recurrence rate among eosinophilic type was significantly higher than other types (54.5% compared to 13.3%, respectively).

Conclusions: Presence of mucosal eosinophilia is a more important factor than nasal polyps for classifying CRS in terms of the surgical outcome. Patients with mucosal eosinophilia had higher polyp recurrence rate than patients without mucosal eosinophilia, whereas patients with nasal polyps did not have higher polyp recurrence rate than patients without nasal polyps.


Keywords


Eosinophils, Nasal polyps, Endoscopic sinus surgery, Recurrence

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References


Mills SE. Nose, paranasal sinuses, and nasopharynx. In: Mills SE, Greenson JK, Hornick JL, Longacre TA, Reuter VE, editors. Stenberg’s diagnostic surgical pathology, vol. 952: Wolters Kluwer Health; 2015.

Couto LGF, Fernades AM, Brandão DF, Santi Neto D, Valera FCP, AnselmoLima WT. Histological aspects of rhinosinusal polyps. Braz J Otorhinolaryngol. 2008; 74(2):207-12.

Jankowski R, Bouchoua F, Coffinet L, Vignaud JM. Clinical factors influencing the eosinophil infiltration of nasal polyps. Rhinology. 2002;40:173-8.

Ogata Y, Okinaka Y, Takahashi M. Detection of activated eosinophils in nasal polyps of an aspirin-induced asthma patient. Rhinology. 1999;37:16-20.

Pawankar R. Nasal polyposis: an update: editorial review. Curr Opin Allergy Clin Immunol. 2003;3:1-6.

Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps 2007. Rhinol Suppl. 2007;(20):1-136.

Steinke JW, Bradley D, Arango P, Crouse CD, Frierson H, Kountakis SE, et al. Cysteinyl leukotriene expression in chronic hyperplastic sinusitis-nasal polyposis: importance to eosinophilia and asthma. J Allergy Clin Immunol. 2003;111:342-9.

Voegels RL, Santoro P, Butugan O, Formigoni LG. Nasal polyposis and allergy: is there a correlation? Am J Rhinol. 2001;15:9-14.

Dursun E, Korkmaz H, Eryilmaz A, Bayiz U, Sertkaya D, Samim E. Clinical predictors of long-term success after endoscopic sinus surgery. Otolaryngol Head Neck Surg. 2003;129:526-531.

Snidvongs K, Lam M, Sacks R, Earls P, Kalish L, Philips S, et al. Structured histopathology profiling of chronic rhinosinusitis in routine practice. Int Forum Allergy Rhinol. 2012;2:376-385.

Lund V, Kennedy D. Staging for rhinosinusitis. Otolaryngol Head Neck Surg. 1997;117:35-40.

Bryson JM, Tasca RA, Rowe-Jones JM. Local and systemic eosinophilia in patients undergoing endoscopic sinus surgery for chronic rhinosinusitis with and without polyposis. Clin Otolaryngol. 2003;28:55-58.

Ishitoya J, Sakuma Y, Tsukuda M. Eosinophilic chronic rhinosinusitis in Japan. Allergol Int. 2010;59:239-45.

Mygind N. Nasal polyposis. J Allergy Clin Immunol. 1990;86:827-9.

Kirtsreesakul V, Atchariyasathian V. Nasal polyposis: role of allergy on therapeutic response of eosinophil- and noneosinophil-dominated inflammation. Am J Rhinol. 2006;20:95-100.

Hao J, Pang YT, Wang DY. Diffuse mucosal inflammation in nasal polyps and adjacent middle turbinate. Otolaryngol Head Neck Surg. 2006;134:267-75.

Gerstner AO, Gutsche M, Bucheler M, Machlitt J, Emmrich F, Sommerer F, et al. Eosinophilia in nasal polyposis: its objective quantification and clinical relevance. Clin Exp Allergy. 2004;34:65-70.

Van Bruaene N, Perez-Novo CA, Basinski TM, Van Zele T, Holtappels G, De Ruyck N, et al. T-cell regulation in chronic paranasal sinus disease. J Allergy Clin Immunol. 2008;121:1435-41.

Tosun F, Arslan HH, Karslioglu Y, Deveci MS, Durmaz A. Relationship between postoperative recurrence rate and eosinophil density of nasal polyps. Ann Otol Rhinol Laryngol. 2010;119:455-9.

Nakayama T, Yoshikawa M, Asaka D, Okushi T, Matsuwaki Y, Otori N, et al. Mucosal eosinophilia and recurrence of nasal polyps-new classification of chronic rhinosinusitis. Rhinology. 2011;49:392-6.

Lackner A, Raggam RB, Stammberger H, Beham A, Braun H, Kleinhappl B, et al. The role of interleukin-16 in eosinophilic chronic rhinosinusitis. Eur Arch Otorhinolaryngol. 2007;264:887-93.

Boztepe OF. Gun T, Demir M, Gur OE, Ozel D, Dogru H. A novel predictive marker for the recurrence of nasal polyposis following endoscopic sinus surgery. Eur Arch Otorhinolaryngol. 2016;273:1439-44.

Ferguson BJ. Categorization of eosinophilic chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2004;12:237-42.

Soler ZM, Sauer D, Mace J, Smith TL. Impact of mucosal eosinophilia and nasal polyposis on quality-of-life outcomes after sinus surgery. Otolaryngol Head Neck Surg. 2010;142:64-71.

Meloni F, Stomeo F, Teatini GP. Postoperative recurrence of naso-sinus polyposis. Acta Otorhinolaryngol Ital. 1990;10:173-9.