The new histologic classification of chronic rhinosinusitis

Abstract

Two histologic patterns of disease are found in chronic rhinosinusitis. The first is dominated by eosinophilia and polypoid changes. Glandular hyperplasia and hypertrophy characterize the second. We present the evidence supporting the existence of these two patterns of disease and link these histologic patterns to the larger pathophysiologic processes that drive them. This histologic classification should be acknowledged both in the clinical setting and in laboratory research of chronic rhinosinusitis.

Normalization of maxillary sinus mucosa after functional endoscopic sinus surgery in pediatric chronic sinusitis

“…Accordingly, for the purposes of assessing post-FESS mucosal changes in this study, the pathological maxillary sinus mucosa were categorized as either edematous or polypoid, based on macroscopic observation during endoscopy. This corresponded to Malekzadeh and McGuires' [14] histological classification of diseased antral mucosa.…”

Surfactant Protein B Detection and Gene Expression in Chronic Rhinosinusitis

“…In addition to the obvious underlying genetic component, CF CRS has frequent, robust infections with glandular hyperplasia and neutrophilic inflammation. CRS with NP and AFRS are characterized by eosinophilic inflammation and polypoid changes 24 . Furthermore, the up‐regulation noted in these patients could be secondary to preoperative corticosteroid use.…”

Chronic Rhinosinusitis without Nasal Polyps

“…The increase in mucous gland density occurs in severe CRSsNP subjects, while those with nasal polyps show a significant decrease in mucous gland density. 28,57–60 Glandular hypertrophy and mucous secretion in the airway mucosa are likely to be mediated by the cytokines, tumor necrosis factor (TNF)-α, IL-8 and IL-13. 61–63 MUC5AC and MUC5B are the main secreted mucins in the human airway, with MUC5A produced primarily by goblet cells.…”