Ciliary function and sinonasal mucosal cytology in pediatric  patients with chronic rhinosinusitis during a year after  functional endoscopic sinus surgery

Alekseenko, Svetlana I.; Karpishchenko, S. А.; Artyushkin, S. A.; Barashkova, S. V.; Anikin, I. A.

doi:10.4193/rhin20.642

Cited by 5 publications

(3 citation statements)

References 50 publications

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“…При этом в раннем послеоперационном периоде может отмечаться не только отсутствие положительной динамики, но и угнетение цилиарной активности, что обусловлено воспалительной реакцией. Устойчивое улучшение наблюдается с 6-9 месяцев и достигает нормальных показателей лишь через год после оперативного вмешательства [18]. Учитывая роль нарушений мукоцилиарного клиренса в патогенезе ХРС [2], нарушения функционирования цилиарного аппарата в послеоперационном периоде могут рассматриваться в качестве фактора риска рецидива ХРС.…”

Section: Discussionunclassified

Effect of concomitant nasal septum deviation on mucociliary clearance parameters after pediatric sinus surgery

Alekseenko¹,

Dvoryanchikov²,

Artyushkin³

et al. 2022

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Objective. To analyze the effect of concomitant deviated nasal septum in children with chronic rhinosinusitis (CRS) on the effectiveness of functional endoscopic sinus surgery (FESS), the state of the ciliary apparatus, and the morphology of the nasal mucosa in the postoperative period. Patients and methods. A comprehensive examination was performed in 124 patients with CRS without nasal septum deviation as well as 66 patients with CRS and concomitant nasal septum deviation who underwent FESS. Results. A statistically significant improvement in the condition of the subjects after surgery was found in both groups. At the same time, patients with CRS and nasal septum deviation had a higher number of complications and the need for revision surgery. The subjective evaluation of the results of FESS was significantly higher in the group of children with CRS without nasal septum deviation. According to the results of video cytomorphometry in children with CRS without deviated nasal septum, by 6 and 12 months of the postoperative period, there was a close to significant and significant increase in the survival of epithelial cells, the number of cells with mobile cilia, the length of cilia, and the frequency of cilia beating. A year after the operation, this group of subjects also showed a statistically significant decrease in epithelial dystrophy, the number of neutrophils and lymphocytes, and a tendency to arrange cells in layers. In contrast, in patients with CRS and nasal septum deviation, a significant increase in the length of cilia was noted only by 12 months after surgery, while other parameters only tended to normalize. Synchronicity of cilia beat increased significantly by 12 months in both groups. Thus, the obtained results indicate a delayed recovery of the ciliary apparatus and the morphology of the ciliated epithelium mucosa after FESS in children with CRS and concomitant nasal septum deviation, which may be associated with persistent inflammation, causing a less favorable course of the postoperative period.

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Section: Discussionunclassified

Effect of concomitant nasal septum deviation on mucociliary clearance parameters after pediatric sinus surgery

Alekseenko¹,

Dvoryanchikov²,

Artyushkin³

et al. 2022

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“…В частности, показано, что выраженность дисфункции цилиарного аппарата связана как с тяжестью клинического течения ХРС [4], так и эффективностью его лечения [5]. В ходе ранее проведенных нами исследований продемонстрировано, что, несмотря на значительное улучшение общего состояния после проведения ФЭРСХ, восстановление функционирования цилиарного аппарата у детей занимает длительный период вплоть до года [6]. При этом нарушение МЦТ наряду с персистированием воспаления может рассматриваться в качестве фактора снижения эффективности ФЭРСХ.…”

Section: The Impact Of Allergic Rhinitis On Ciliary Function Of Nasal...unclassified

The Impact of Allergic Rhinitis on Ciliary Function of Nasal Mucosa in Children With Chronic Rhinosinusitis in Postoperative Period

Alekseenko¹,

Dvoryanchikov²,

Artyushkin³

et al. 2022

СПНО (MPSE)

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The objective of the study is investigation of the impact of allergic rhinitis on ciliary function in children with chronic rhinosinusitis in postoperative period. A total of 131 pediatric patients aged 4-17 years old were involved in the present study. All patients were subjected to functional endoscopic sinonasal surgery. Depending on the presence of allergic rhinitis all examinees were divided into two groups, namely patients with CRS and AR (n = 20) and AR-free CRS patients (n = 111). Assessment of sinonasal pathology was performed using Sino-Nasal-Outcome-Test 20 (SNOT-20) questionnaire, as well as endoscopic and radiological investigation with subsequent evaluation of Lund-Kennedy and Lund-Mackay scores, respectively. Investigation of ciliary function, morphology, and cytology of nasal mucosa was performed using videocytometric analysis. The obtained data demonstrate that sinonasal pathology was significantly (p < 0,001) reduced after surgical treatment of CRS independently of AR status. At the same time, AR possessed a significant impact on reparation of nasal mucosa ciliary function and morphology in the postoperative period. Specifically, at 12 months after the surgery pediatric patients with CRS and AR were characterized by a twofold lower relative number of cells with motile cilia (р = 0,009), twofold lower number of cases of ciliary beat synchronicity (р = 0,035), a 26 % reduction in cell survival (р = 0,025), as well as 90 % higher number of cases with severe epithelial dystrophy (р = 0,030) as compared to AR-free CRS patients. Therefore, the obtained data demonstrate that AR significantly affects postoperative mucosal reparation in CRS patients after functional endoscopic sinonasal surgery.

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“…A prospective observational study of 39 children affected by CRSwNP (mean age 10.9 years) undergoing ESS demonstrated an improvement in quality of life after surgery [69]. Likewise, another non-randomized controlled prospective study showed that SNOT-22, Lund-Mackay, and Lund-Kennedy scores improved after ESS in 132 children with pediatric CRS compared to 15 healthy controls [70].…”

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confidence: 98%

Care for Patients with Type-2 Chronic Rhinosinusitis

Giunta

Pirola

Giombi

et al. 2023

JPM

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In the last 20 years, growing interest in chronic rhinosinusitis (CRS) has become evident in medical literature; nevertheless, it is still difficult to identify the real prevalence of the disease. Epidemiological studies are few and focused on heterogeneous populations and diagnostic methods. Recent research has contributed to identifying CRS as a disease characterized by heterogeneous clinical scenarios, high impact on quality of life, and elevated social costs. Patient stratification with phenotypes and identification of the pathobiological mechanism at the origin of the disease (endotype) and its comorbidities are pivotal in the diagnostic process, and they should be addressed in order to properly tailor treatment. A multidisciplinary approach, shared diagnostic and therapeutic data, and follow-up processes are therefore necessary. Oncological multidisciplinary boards offer models to imitate in accordance with the principles of precision medicine: tracing a diagnostic pathway with the purpose of identifying the patient’s immunological profile, monitoring therapeutical processes, abstaining from having only a single specialist involved in treatment, and placing the patient at the center of the therapeutic plan. Awareness and participation from the patient’s perspective are fundamental steps to optimize the clinical course, improve quality of life, and reduce the socioeconomic burden.

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Ciliary function and sinonasal mucosal cytology in pediatric patients with chronic rhinosinusitis during a year after functional endoscopic sinus surgery

Cited by 5 publications

References 50 publications

Effect of concomitant nasal septum deviation on mucociliary clearance parameters after pediatric sinus surgery

Effect of concomitant nasal septum deviation on mucociliary clearance parameters after pediatric sinus surgery

The Impact of Allergic Rhinitis on Ciliary Function of Nasal Mucosa in Children With Chronic Rhinosinusitis in Postoperative Period

Care for Patients with Type-2 Chronic Rhinosinusitis

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