Does Eosinophilic Inflammation Affect the Outcome of Endoscopic Sinus Surgery in Chronic Rhinosinusitis in Koreans?

Kim, So Young; Park, Joo Hyun; Rhee, Chae Seo; Chung, Jin Haeng; Kim, Jeong Whun

doi:10.2500/ajra.2013.27.3959

Cited by 29 publications

(30 citation statements)

References 29 publications

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“…ECRS patients represent a unique subtype, as they appear to be more resistant to current medical and surgical interventions . There is currently a substantial amount of evidence associating ECRS patients with a greater tendency for recurrence of nasal polyps after endoscopic sinus surgery (ESS) . Recurrence of nasal polyps poses a significant challenge for otolaryngologists, with long‐term recurrence rates ranging from 15% to as high as 50% .…”

Section: Comparison Of Ecrs and Necrs Characteristic Features*mentioning

confidence: 99%

High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta‐analysis

McHugh

Snidvongs

Xie

et al. 2018

Int Forum Allergy Rhinol

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Section: Comparison Of Ecrs and Necrs Characteristic Features*mentioning

confidence: 99%

High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta‐analysis

McHugh

Snidvongs

Xie

et al. 2018

Int Forum Allergy Rhinol

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“…Others have proposed that local release of interleukin 5 (IL‐5) and IL‐13 due to fungal organisms inhabiting the sinonasal mucosa of a susceptible host can lead to unrelenting eosinophilic inflammation . Interestingly, while eCRS is commonly associated with presence of nasal polyps, up to 40% of CRSsNP patients also have elevated tissue eosinophils …”

mentioning

confidence: 99%

Role of tissue eosinophils in chronic rhinosinusitis–associated olfactory loss

Hauser

Chandra

et al. 2017

Int Forum Allergy Rhinol

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Introduction Olfactory dysfunction is one of the hallmark symptoms of chronic rhinosinusitis (CRS). Eosinophilic inflammation has been implicated as a potential causative factor. However, prior studies have been limited by retrospective study designs, concomitant use of systemic corticosteroids, and other confounding factors. Methods CRS and healthy non-CRS control subjects undergoing endoscopic sinus or skull base surgery were prospectively enrolled and completed olfactory testing utilizing the 40-item Smell Identification Test (SIT) immediately prior to surgery. Histopathological evaluation of tissue excised from the ethmoid bulla was performed by a pathologist in a blinded fashion. Disease severity and patient reported outcomes were measured via the Lund-Mackay CT grading system and Sinonasal Outcome Test-22, respectively. The associations between olfactory function, tissue eosinophilia, and disease severity were analyzed using Spearman rank order correlation and multiple linear regression. Results 27 subjects with CRS without nasal polyps (CRSsNP), 32 subjects with CRS with nasal polyps (CRSwNP), and 10 healthy non-CRS controls were enrolled. CRSwNP was associated with higher mean tissue eosinophil counts (71.6 vs. 28.1 eosinophils/HPF, p<0.05) and lower age/sex-adjusted SIT scores (−17.4 vs. −6.2, p<0.001) when compared to CRSsNP. SIT scores were strongly negatively correlated with tissue eosinophil counts in CRSwNP (r=−0.60, p=0.0003), but not CRSsNP (r=0.16, p=0.42). The correlation between olfactory function and tissue eosinophilia in CRSwNP persisted after adjusting for disease severity. Conclusions Tissue eosinophilia is associated with olfactory loss in CRSwNP, independent of disease severity. These results suggest a possible role for eosinophils or eosinophil-associated cytokines in CRS-associated olfactory loss.

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“…In fact, eosinophilia was a reliable marker for severe and refractory sinusitis. Some studies focusing on the degree of tissue eosinophilia in chronic sinusitis and its bearing on the severity of CRS, which revealed the presence of peripheral eosinophilia in patients with sinusitis, indicated a high likelihood of extensive disease [9], but neither serum nor tissue eosinophilia predicted disease severity in CRSwNP patients [10, 11]. Sinonasal tissue eosinophilia is present in the majority of CRSwNP patients but it is currently more common in the West than in the East [12].…”

Section: Introductionmentioning

confidence: 99%

Impact of Allergy and Eosinophils on the Morbidity of Chronic Rhinosinusitis with Nasal Polyps in Northwest China

Chen

Qiao

et al. 2019

Int Arch Allergy Immunol

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Background: Nasal polyps are a common health problem that can significantly impact the quality of life. Objective: To analyze the impact of allergy and peripheral eosinophils (EOS) on the morbidity of chronic rhinosinusitis with nasal polyps (CRSwNP) in Northwest China. Methods: A retrospective cohort of 323 patients who underwent endoscopic sinus surgery (ESS) for chronic rhinosinusitis without nasal polyps (CRSsNP) and CRSwNP in Xijing Hospital was studied between January 5, 2011, and January 4, 2015. All of the patients underwent an allergen skin prick test and peripheral blood EOS inspection. Detailed information regarding the impact of allergy and EOS on the morbidity of CRSwNP was collected. Potential risk factors associated with nasal polyps were explored using logistic regression analysis. Multivariate logistic regression was performed to identify independent risk factors. Results: The results revealed that EOS is an important risk factor for nasal polyps. In the univariate analysis, the adjusted OR was 2.01 (95% CI 1.08–3.72; p = 0.027). In the multivariate analysis, the adjusted OR was 2.02 (95% CI 1.08–3.76; p = 0.027). Compared to allergic rhinitis and normal EOS levels, nonallergic rhinitis and elevated EOS levels constituted a risk factor for CRSwNP (OR = 2.70; 95% CI 1.32–5.50). Compared to allergen-positive and EOS-normal status, allergen-negative and elevated-EOS status constituted a risk factor for CRSwNP (OR = 2.95; 95% CI 1.38–6.33). Conclusion: EOS is a significant factor related to the morbidity of CRSwNP in Northwest China. Elevated EOS levels occurring in the context of nonallergic rhinitis constitute a risk factor for CRSwNP. Similarly, elevated EOS levels occurring in the context of allergen-negative rhinitis are also an important risk factor for morbidity of CRSwNP.

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Does Eosinophilic Inflammation Affect the Outcome of Endoscopic Sinus Surgery in Chronic Rhinosinusitis in Koreans?

Abstract: The results suggest that eosinophilic inflammation in CRS may not be related to the surgical outcome in Koreans.

Cited by 29 publications

References 29 publications

High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta‐analysis

High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta‐analysis

Role of tissue eosinophils in chronic rhinosinusitis–associated olfactory loss

Impact of Allergy and Eosinophils on the Morbidity of Chronic Rhinosinusitis with Nasal Polyps in Northwest China

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