Can a panel of clinical, laboratory, and pathological variables pinpoint patients with sinonasal polyposis at higher risk of recurrence after surgery?

The prognostic role of serum eosinophil and basophil levels in sinonasal polyposis

“…A direct association between CRSwNP recurrence rates and serum hypereosinophilia was recently reported by Ikeda et al., Ottaviano et al., and Tokunaga et al . A recent preliminary investigation conducted by our own research group also showed a significant direct association between CRSwNP recurrence rates and serum basophil counts . When the neutrophil‐to‐lymphocyte ratio (NLR) was investigated vis‐a‐vis CRSwNP recurrence after surgery, it was found to be significant higher in patients whose disease recurred than in those remaining disease‐free .…”

A classification of chronic rhinosinusitis with nasal polyps based on structured histopathology

“…Chronic rhinosinusitis is a complex disorder characterised by persistent inflammation of the sinonasal mucosa . A better understanding of the pathological mechanisms underlying it has prompted an endotyping approach to the disease, with subtypes being defined functionally and pathologically according to specific cellular and molecular mechanisms . Cluster analysis can facilitate the subtyping of heterogeneous disorders, and has recently been used in various settings .…”

“…14 A better understanding of the pathological mechanisms underlying it has prompted an endotyping approach to the disease, with subtypes being defined functionally and pathologically according to specific cellular and molecular mechanisms. 1,9,15 Cluster analysis can facilitate the subtyping of heterogeneous disorders, and has recently been used in various settings. 16 Nakayama et al 17 used cluster analysis in a multicentre study on clinical data from chronic rhinosinusitis patients treated at five hospitals.…”

Using postoperative SNOT-22 to help predict the probability of revision sinus surgery

“…On an aggregate CRS scale, several studies have quantified the 5-year risk of requiring revision ESS to be between 10% and 20% (7)(8)(9)(10)(11) , while the presence of certain comorbidities such as asthma and aspirin sensitivity, along with other factors such as having high baseline computed tomography (CT) staging (12) or incomplete sinus dissection (13) have been associated with elevated revision rates between 25% and 40% (8)(9)(10)12) . Other high risk factors for revision ESS include predominant Th2 type inflammation (14) and high tissue eosinophilia (15,16) . However, despite the presence of known risk factors for revision surgery, evidence for several of these clinical characteristics have failed to reliably predict revision ESS (3,17,18) and the immunologic measures can be difficult to standardize and interpret for clinical use.…”