Chronic Eosinophilic Rhinosinusitis Clinical Implications

Abdulla, Amal Al; Darwish, Abdulla; Bella, Mohamed Hassan

doi:10.12816/0047528

Cited by 5 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Amal et al reported headache in 24 of 59 (40.7%) patients with CRSwNP who underwent surgery. They also found a predominance of headache in the ECRS group (46.1%) compared to the No ECRS group (35.5%) [21]. The incidence of headache in our ECRS group was 55%, which is very similar to that reported by Amal et al In this study, the characteristics of the headache in group S were very similar to those of migraine headaches.…”

Section: Discussionsupporting

confidence: 90%

Therapeutic Effects of Endoscopic Sinus Surgery in Eosinophilic Sinusitis Patients with Severe Headache

2022

J Surg

View full text Add to dashboard Cite

Background: Eosinophilic Chronic Rhinosinusitis (ECRS) is an intractable disease with symptoms that affect daily life, such as nasal obstruction and olfactory disturbances. Among the symptoms, headache is the symptom that most affects daily life. Method:In this study, we examined and compared the clinical findings of 40 ECRS patients who underwent Endoscopic Sinus Surgery (ESS) at our hospital, focusing on eight patients who complained of severe headache. The 40 ECRS patients were divided into three groups: those with severe headache (group S) (n=8), moderate headache (group M) (n=14), and without headache (group N) (n=18), and the clinical features in each group were compared. The six main symptoms of the three groups were compared using the Nasal Symptoms Questionnaire (NSQ) before and 2 years after surgery.Results: In group S, there was a significant improvement in headache after ESS in all patients (P<0.05). In the S+M group, 91% of patients showed improvement in headache after ESS. In each of the three groups, most of the symptoms, and not only headache, were significantly improved after ESS. In group S, six patients (75%) expressed preoperative improvement in headache symptoms with oral steroids. This suggests that it might be possible to preoperatively determine whether headache is caused by ECRS or other causes based on whether it improves with preoperative steroid therapy. Intergroup comparisons showed that more patients in group S had a short anteroposterior diameter of the frontal sinus than in the other groups, and evaluation indicated that ECRS patients with a short antero-posterior diameter of the frontal sinus are more likely to have severe headache. Conclusion:ESS led to a significant improvement in all symptoms in ECRS cases. Severe headache is known to interfere with daily life in ECRS patients. We speculated that patients with severe headaches might show a relatively greater improvement in headache severity after ESS. However, since ECRS is a recurrent disease, postoperative follow-up and treatment, such as with nasal rinses and steroid nasal sprays, are very important for maintaining the efficacy of surgery.

show abstract

Section: Discussionsupporting

confidence: 90%

Therapeutic Effects of Endoscopic Sinus Surgery in Eosinophilic Sinusitis Patients with Severe Headache

2022

J Surg

View full text Add to dashboard Cite

show abstract

“…Facial pain, nasal congestion, loss of smell, sneezing, and headache were the most commonly reported symptoms for patients with CRSwNP. Facial pain was reported for 60-92.2% of patients in North America 16,27 , 31-45% of patients in Europe 28,29 , and 19-100% of patients in Asia [30][31][32][33] . Nasal congestion was reported in 95-100% of patients with CRSwNP in North America 17,27 , 73-88% of patients in Europe 34,35 , and 76-81% of patients in Asia 31,36 .…”

Section: Symptomsmentioning

confidence: 99%

“…Facial pain was reported for 60-92.2% of patients in North America 16,27 , 31-45% of patients in Europe 28,29 , and 19-100% of patients in Asia [30][31][32][33] . Nasal congestion was reported in 95-100% of patients with CRSwNP in North America 17,27 , 73-88% of patients in Europe 34,35 , and 76-81% of patients in Asia 31,36 . Loss of smell was reported for 56-84% of patients with CRSwNP in North America 16,27 , 35-90% of patients in Europe 28,34,35,37,38 , and 30-100% of patients in Asia [30][31][32]36,39 .…”

Section: Symptomsmentioning

confidence: 99%

“…Nasal congestion was reported in 95-100% of patients with CRSwNP in North America 17,27 , 73-88% of patients in Europe 34,35 , and 76-81% of patients in Asia 31,36 . Loss of smell was reported for 56-84% of patients with CRSwNP in North America 16,27 , 35-90% of patients in Europe 28,34,35,37,38 , and 30-100% of patients in Asia [30][31][32]36,39 . Sneezing was reported for 88% of patients in North America 26 , 12-73% of patients in Europe 28,34,35,38 , and 27-51% of patients in Asia 31,33 .…”

Section: Symptomsmentioning

confidence: 99%

“…Loss of smell was reported for 56-84% of patients with CRSwNP in North America 16,27 , 35-90% of patients in Europe 28,34,35,37,38 , and 30-100% of patients in Asia [30][31][32]36,39 . Sneezing was reported for 88% of patients in North America 26 , 12-73% of patients in Europe 28,34,35,38 , and 27-51% of patients in Asia 31,33 . Headache was reported for 33-95.8% of patients in North America 27,40 , 20-41% of patients in Europe 33,34 , and 2-76% of patients in Asia 33,36 .…”

Section: Symptomsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic literature review of the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyposis

Chen

Zhou

Emmanuel

et al. 2020

Current Medical Research and Opinion

View full text Add to dashboard Cite

Objectives: We conducted a systematic literature review (SLR) to determine the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyps (CRSwNP) and to describe how the addition of biologics has affected outcomes for patients with CRSwNP. Methods: The SLR adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Embase, MEDLINE, and Evidence-Based Medicine Reviews databases were searched using OVID. Relevant studies published between 1

show abstract

Evaluation of Diffuse Type 2 Dominant or Eosinophilic Chronic Rhinosinusitis With Corticosteroid Irrigation After Surgical Neosinus Cavity Formation

Grayson

Alvarado

et al. 2021

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

IMPORTANCE Eosinophilic chronic rhinosinusitis (eCRS), contemporarily classified as diffuse type 2 dominant chronic rhinosinusitis (CRS), is characterized by eosinophil-dominant mucosal inflammation. Contemporary management of eCRS as an inflammatory airway condition is multimodal with corticosteroid irrigations after the surgical creation of a neosinus cavity.OBJECTIVES To assess long-term treatment outcomes in patients with primary diffuse type 2 CRS or eCRS receiving multimodal treatment. DESIGN, SETTING, AND PARTICIPANTSA prospective cohort study of patients seen in a tertiary rhinology practice recruited from May 2010 to November 2018 was conducted. Follow-up duration was 12 months or more following endoscopic sinus surgery (ESS) with a neosinus cavity formed. Data analysis was performed from August to November 2020. Consecutive adult (Ն18 years) patients diagnosed with primary diffuse type 2 dominant CRS or eCRS based on the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 criteria were included. Type 2 inflammation was defined as more than 10 eosinophils per high-power field obtained from sinus mucosal biopsy and managed with neosinus cavity ESS and ongoing corticosteroid irrigations. Exclusion criteria were less than 12 months of follow-up and secondary CRS.INTERVENTIONS Endoscopic sinus surgery with complete removal of intersinus bony partitions to create a neosinus cavity. Nasal irrigation (240 mL) with betamethasone, 1 mg, or budesonide, 1 mg, daily for 3 to 6 months after ESS and tapered to an as-needed basis (minimum, 2-3 per week). MAIN OUTCOMES AND MEASURESPoor control was defined as polyp recurrence (polyp growth in >1 sinus area on a single side), use of long-term systemic therapy (biologic therapy or Ն3 consecutive months of oral corticosteroids), and revision surgery involving polypectomy. The disease in patients with no poor control criteria was defined as well controlled, and the disease in those with 1 or more criteria was considered poorly controlled. Maintenance medical therapy use and patient-reported outcomes based on the 22-item Sinonasal Outcomes Test for preoperative and last follow-up were collected. RESULTSOf the 222 participants recruited with primary diffuse type 2 dominant CRS or eCRS and minimum of year of follow-up, 126 were men (56.8%). Mean (SD) age was 54.8 (13.6) years, and median (SD) follow-up was 2.2 (2.2) years. Of the 222 patients, 195 (87.8%) had well-controlled disease, 16 (7.2%) had polyp recurrence, 7 (3.2%) continued to receive long-term oral corticosteroid therapy, 5 (2.3%) received biologic therapy, and 8 (3.6%) underwent a revision polypectomy. Clinically meaningful change on the 22-item Sinonasal Outcomes Test and the nasal subdomain score was maintained at the last follow-up in 134 patients (67.0%). Poor disease control was not associated with poor adherence to irrigation use. CONCLUSIONS AND RELEVANCEThe findings of this cohort study suggest that long-term disease control and reduction in symptom burden in patients with primary diffuse type 2 ...

show abstract

Chronic Eosinophilic Rhinosinusitis Clinical Implications

Cited by 5 publications

References 17 publications

Therapeutic Effects of Endoscopic Sinus Surgery in Eosinophilic Sinusitis Patients with Severe Headache

Therapeutic Effects of Endoscopic Sinus Surgery in Eosinophilic Sinusitis Patients with Severe Headache

Systematic literature review of the epidemiology and clinical burden of chronic rhinosinusitis with nasal polyposis

Evaluation of Diffuse Type 2 Dominant or Eosinophilic Chronic Rhinosinusitis With Corticosteroid Irrigation After Surgical Neosinus Cavity Formation

Contact Info

Product

Resources

About