A prospective investigation of predictive parameters for post-surgical recurrences in sinonasal polyposis

Brescia, Giuseppe; Marioni, Gino; Franchella, Sebastiano; Ramacciotti, Giulia; Giacomelli, Luciano; Marino, Filippo

doi:10.1007/s00405-015-3598-5

Cited by 37 publications

(27 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, studies have found eosinophilia in nasal tissue and blood is closely related to surgical outcomes. 5,11,12 Tokunaga et al 13 created a model to classify CRS severity mainly based on blood eosinophil ratio in Japanese CRS patients. However, the degree of eosinophilia has significant geographic and ethnic differences.…”

Section: Introductionmentioning

confidence: 99%

“…15 Moreover, comorbid asthma and computed tomography (CT) scores are considered as risk factors in some studies, 7,13,16 but not in others. 9,17 In addition, researchers have demonstrated that age, 11 gender, 9 previous CRS surgery, 6,9 preoperative endoscopic score, 6 and allergy 11 are also related to poor ESS outcomes. Predictive models with these risk factors for clinical practice are needed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prediction models for postoperative uncontrolled chronic rhinosinusitis in daily practice

et al. 2018

View full text Add to dashboard Cite

Objectives/Hypothesis The European Position Paper on Rhinosinusitis and Nasal Polyps proposes an assessment of clinical control of chronic rhinosinusitis (CRS). However, there are limited data about the percentage of postoperative control, and no prediction models for uncontrolled CRS have been reported. The aim of the study was to develop prediction models for postoperative uncontrolled CRS. Study Design Retrospective case series. Methods Patients (n = 136) who had undergone endoscopic sinus surgery at least 1 year prior to the study were recruited to assess the clinical control. Risk factors were determined by logistic models and presented as odds ratio (OR) with a 95% confidence interval. Receiver operating characteristics curves were constructed to set the cutoff points and create predictive models. Results Approximately 47.8% of patients had controlled, 22.1% partially controlled, and 30.1% uncontrolled CRS. Univariate regression models revealed the risk factors for uncontrolled CRS: tissue eosinophilia, blood eosinophilia, high computed tomography (CT) score, bilateral disease, asthma, and allergic rhinitis. Multiple regression models found tissue eosinophil ratio >0.206 (OR: 12.96, P = .001) or blood eosinophil ratio >0.025 (OR: 4.56, P = .003), Lund‐Mackay (LM) score ≥ 15 (OR: 15.50, P < .001) and CT ethmoid (E) score ≥ maxillary (M) score (OR: 3.51, P = .037) were independent risk factors. We generated a pathological model (tissue eosinophil ratio and LM score) and a clinical model (blood eosinophil ratio, LM score and E ≥ M score) to categorize CRS into mild, moderate, and severe. Conclusions This research provides simplified and efficient prediction models for uncontrolled CRS. It may help otolaryngologists to predict the prognosis before surgery in daily practice. Level of Evidence 2b Laryngoscope, 128:2673–2680, 2018

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prediction models for postoperative uncontrolled chronic rhinosinusitis in daily practice

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The multivariate model presented that there was histological evidence between the eosinophilic type and the recurrence of nasal polyposis (p=0.033). 6 Olszewski et al stated that in their study they did 278 polipectomies, 6 months after FESS, by endoscopic examination there were patent paranasal sinuses ostiums, there were no inflammatory traits as swelling, redness of the nasal mucosa or any pathological secretion. There was adequate nasal patency in 93.7%, patients sensed of the blood flowing down to the mouth in 20.4%, mucorrhoea in 2.8%, impaired smell in 17.6% and headache in 2.8%.…”

Section: Resultsmentioning

confidence: 95%

Grafting to denuded nasal cavity for prevention of recurrent nasal polyposis by endoscopic sinus surgery

Amin

Mandour

Elrefai

2018

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

Background: The objective of the study was to avoid nasal polyposis occurrence after recurrent FEES.Methods: 87 patients undergoing recurrent FESS due to recurrent nasal polyposis, after completing all steps of FESS the placement of normal nasal mucosa from inferior turbinate or nasal septum instead of the mucosa of the fovea ethmoidalis and lamina papyracea was done. Results: There were nasal obstruction improvement in 79 patients (90.8%), but there were 8 patients (9.2%) had recurrent nasal polypi causing nasal obstruction. There was smell improvement in 38 patients (71.7%) out of 15 patients (28.3%).Conclusions: The nasal cavity grafting in FESS of recurrent nasal polyposis with nasal septal or inferior turbinate mucosa had promising results in prevention of nasal polyposis recurrence. These results made a recommendation of nasal cavity grafting during primary FESS of nasal polyposis.

show abstract

“…Nasal inflammatory polyps are nonneoplastic proliferations of the sinonasal mucosa composed of both epithelial and stromal elements. The pathogenesis of these lesions is still uncertain; however, mucosal edema and inflammation, cytokine secretion, and collagen synthesis stimulated by eosinophils have all been implicated 1,2,3 ; polyps are frequently associated with salicylates intolerance, asthma and cystic fibrosis 1,2,3,4,5,6,7,8,9 . Symptoms at presentation include nasal obstruction, rhinorrhea, headache, impaired sense of smell and postnasal discharge 1,2,3,4,5,6 .…”

Section: Introductionmentioning

confidence: 99%

“…Patients who have failed medical management may benefit from surgical intervention in the form of transnasal ethmoidectomy or, more recently, functional endoscopic nasal surgery. Even after appropriate surgical therapy, a significant number of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) experience recurrences 9 , with diseasefree interval significantly shorter in patients with eosinophilic-type polyposis. NP often present as multiple bilateral masses arising from the lateral nasal wall.…”

Section: Introductionmentioning

confidence: 99%

Nasal polyposis: A semiquantitative morphometric histopathological study

et al. 2020

View full text Add to dashboard Cite

Background / Aim. Nasal polyps are inflammatory hypertrophic proliferations of the sinonasal mucosa composed of both epithelial and stromal elements. The aim of this study was to determine histopathological hallmarks of nasal polyposis via semiquantitative morphometric study. Methods. Study was designed as prospective study with semiquantitative morphometric analysis and it comprised 77 patients with chronic rhinosinusitis and nasal polyposis that underwent functional endoscopic sinonasal surgery performed by the same surgeon. Morphometric analysis included gradation of tissue edema within polyps, thickening of epithelial basal membrane, degree of inflammation, presence/absence of metaplasia within epithelium, degree of fibrosis within polyps, and percentage of inflammatory cells within inflammatory infiltrate (lymphocytes, macrophages, plasma cells, neutrophils and eosinophils). Results. As expected, samples from study group showed significantly higher degree of inflammation than samples from control group (χ 2 =35.89 with p value less than 0.01). Degree of fibrosis in nasal polyposis is in positive correlation with duration of symptoms (r = 0.25, p < 0,05) and with percentage of macrophages in inflammatory infiltrate (r = 0.26, p < 0.05).. Patients with NP had significantly lower number of lymphocytes (r=-7.66, p < 0.01), but significantly higher number of eosinophils (r=3.84, p < 0.01), macrophages (r=3.34, p < 0.01) and plasma cells (r=3.14, p < 0.01) than controls, with p value less than 0.01. Conclusion. Tissue samples from patients with nasal polyposis show significant changes that reflect in various degrees of inflammation, fibrosis and basement membrane thickening which may contribute to more difficult surgical management and perioperative complications such as bleeding.

show abstract

A prospective investigation of predictive parameters for post-surgical recurrences in sinonasal polyposis

Cited by 37 publications

References 20 publications

Prediction models for postoperative uncontrolled chronic rhinosinusitis in daily practice

Prediction models for postoperative uncontrolled chronic rhinosinusitis in daily practice

Grafting to denuded nasal cavity for prevention of recurrent nasal polyposis by endoscopic sinus surgery

Nasal polyposis: A semiquantitative morphometric histopathological study

Contact Info

Product

Resources

About