Comparative Histopathological Changes Between Primary Versus recurrent Rhinosinusitis With Nasal Polyposis

Abstract

Background: Chronic rhinosinusitis associated with nasal polypi [CRSwNP] is one of the two major chronic rhinosinusitis phenotypes. The histopathological changes of such condition may differ between primary and chronic types. Aim of the work:To differentiate between primary and chronic rhinosinusitis with polypi through detection of the histopathological changes of nasal mucosa. Patients and Methods: Eighty-five patients with CRSwNP scheduled for functional endoscopic sinus surgery [FESS] were divided into two groups; group [1] 35 patients with primary polyposis, group [2] 50 patients with chronic polyposis. A swab was taken from sinus mucosa during FESS and sent for histopathological investigation. Results: We studied 12 histopathogical findings of spacemen of sinus mucosa and found 7 of them had a significant value in comparison between primary and recurrent CRSwNP. The significant increases in chronic recurrent group [2] than primary group [1] were eosinophilic cell count [p=0.044], eosinophilic cell aggregation [p=0.049], basement membrane thickness [P=0.021], Mucosal ulceration [p=0.002], hyperplastic or papillary change [p=0.029], fibrosis [p=0.002] and fungal element [p=0.003]. Conclusion:Histopathological findings of sinus mucosa during FESS operation found to be of great value in differentiating between primary and recurrent CRSwNP, however, further studies on large scale groups were recommended to confirm these results.

Improved sinonasal symptom and endoscopy sinus scores with dose‐escalated intranasal mometasone irrigation in patients with refractory chronic rhinosinusitis

“…For example, a revision FESS CRSwNP control group would enable exploration of whether this population exhibited similar step‐wise improvement with dose escalation. Past studies have shown that patients with revision, relative to primary, FESS CRSwNP demonstrate enhanced fibrosis on histopathology of sinonasal mucosa 9 . Perhaps tissue modification from previous surgical manipulation makes remaining sinonasal tissue less amenable to improvement with topical corticosteroids.…”

“…Past studies have shown that patients with revision, relative to primary, FESS CRSwNP demonstrate enhanced fibrosis on histopathology of sinonasal mucosa. 9 Perhaps tissue modification from previous surgical manipulation makes remaining sinonasal tissue less amenable to improvement with topical corticosteroids. This possibility underscores the importance of individualized medical management of the patient with post-FESS CRSwNP.…”