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Erschienen in: European Archives of Oto-Rhino-Laryngology 8/2018

09.06.2018 | Rhinology

Polypoid change of middle turbinate is associated to an increased risk of polyp recurrence after surgery in patients with chronic rhinosinusitis with nasal polyps

verfasst von: Amin Amali, Ziba Bidar, Sara Rahavi-Ezabadi, Narges Mikaniki, Seyed Mousa Sadrehosseini

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 8/2018

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Abstract

Background

Chronic rhinosinusitis with nasal polyps (CRSwNP) affects approximately 4% of general population. Patients with CRSwNP have greater burden of CRS symptoms and higher rate of relapse after either medical or surgical treatments. The aim of this study was to evaluate the association between polypoid change of anterior free border of middle turbinate and rate of relapse in patients with CRSwNP.

Methods

A controlled prospective cohort study was performed. Seventy-seven adult patients with CRSwNP in whom their MT polypoid change was proved and 77 patients without MT polypoid change were recruited. Allergy, asthma, aspirin hypersensitivity, Lund Kennedy and Lund Mackay scores and eosinophilic scores of polyp and middle turbinate were recorded. Patient’s health-related quality of life was assessed using the 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire. All patients were evaluated 12 months after ESS. Polyp relapse, Lund Kennedy scores and SNOT-22 scores were documented.

Results

The relapse rate in patients with MT polypoid change was significantly higher than the control group (37.14 vs. 20.58, p value = 0.03). Eosinophil score of nasal polyps and MT specimens were significantly higher in patients with MT polypoid change than patients without polypoid change. The postoperative Lund Kennedy and SNOT-22 scores in patients with MT polypoid change were significantly higher than the control group.

Conclusion

This study showed a significant association between polypoid change of anterior free border of middle turbinate and nasal polyp relapse. This new and simple criterion of severity of CRSwNP could have clinical implications.
Literatur
1.
Zurück zum Zitat Hedman J, Kaprio J, Poussa T, Nieminen MM (1999) Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 28:717–722CrossRefPubMed Hedman J, Kaprio J, Poussa T, Nieminen MM (1999) Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 28:717–722CrossRefPubMed
2.
Zurück zum Zitat Banerji A, Piccirillo JF, Thawley SE, Levitt RG, Schechtman KB, Kramper MA, Hamilos DL (2007) Chronic rhinosinusitis patients with polyps or polypoid mucosa have a greater burden of illness. Am J Rhinol 21:19–26CrossRefPubMed Banerji A, Piccirillo JF, Thawley SE, Levitt RG, Schechtman KB, Kramper MA, Hamilos DL (2007) Chronic rhinosinusitis patients with polyps or polypoid mucosa have a greater burden of illness. Am J Rhinol 21:19–26CrossRefPubMed
3.
Zurück zum Zitat Subramanian HN, Schechtman KB, Hamilos DL (2002) A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am J Rhinol 16:303–312PubMedCrossRef Subramanian HN, Schechtman KB, Hamilos DL (2002) A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis. Am J Rhinol 16:303–312PubMedCrossRef
4.
Zurück zum Zitat Pawankar R (2003) Nasal polyposis: an update: editorial review. Curr Opin Allergy Clin Immunol 3:1–6CrossRefPubMed Pawankar R (2003) Nasal polyposis: an update: editorial review. Curr Opin Allergy Clin Immunol 3:1–6CrossRefPubMed
5.
Zurück zum Zitat Larsen K (1996) The clinical relationship of nasal polyps to asthma. Allergy Asthma Proc 17:243–249CrossRefPubMed Larsen K (1996) The clinical relationship of nasal polyps to asthma. Allergy Asthma Proc 17:243–249CrossRefPubMed
6.
Zurück zum Zitat Settipane GA, Chafee FH (1977) Nasal polyps in asthma and rhinitis. A review of 6,037 patients. J Allergy Clin Immunol 59:17–21CrossRefPubMed Settipane GA, Chafee FH (1977) Nasal polyps in asthma and rhinitis. A review of 6,037 patients. J Allergy Clin Immunol 59:17–21CrossRefPubMed
7.
Zurück zum Zitat Grzanka A, Misiołek M, Golusin´ski W, Jarza˛b J (2011) Molecular mechanisms of glucocorticoids action: implications for treatment of rhinosinusitis and nasal polyposis. Eur Arch Otorhinolaryngol 268:247–253CrossRefPubMed Grzanka A, Misiołek M, Golusin´ski W, Jarza˛b J (2011) Molecular mechanisms of glucocorticoids action: implications for treatment of rhinosinusitis and nasal polyposis. Eur Arch Otorhinolaryngol 268:247–253CrossRefPubMed
8.
Zurück zum Zitat Fokkens W, Lund V, Mullol J (2007) European Position Paper on Rhinosinusitis and Nasal Polyps Group, EP3OS 2007: a summary for otorhinolaryngologists. Rhinology 45:97–101PubMed Fokkens W, Lund V, Mullol J (2007) European Position Paper on Rhinosinusitis and Nasal Polyps Group, EP3OS 2007: a summary for otorhinolaryngologists. Rhinology 45:97–101PubMed
9.
Zurück zum Zitat Dalziel K, Stein K, Round A, Garside R, Royle P (2003) Systematic review of endoscopic sinus surgery for nasal polyps. Health Technol Assess 7:1–159CrossRef Dalziel K, Stein K, Round A, Garside R, Royle P (2003) Systematic review of endoscopic sinus surgery for nasal polyps. Health Technol Assess 7:1–159CrossRef
10.
Zurück zum Zitat Wynn R, Har-El G (2004) Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 114:811–813CrossRefPubMed Wynn R, Har-El G (2004) Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 114:811–813CrossRefPubMed
11.
Zurück zum Zitat Cortesina G, Cardarelli L, Riontino E, Majore L, Ragona R, Bussi M (1999) Multi-center study of recurrent nasal sinus polyposis: prognostic factors and possibility of prophylaxis. Acta OtorhinolaryngolItal 19:315–324 Cortesina G, Cardarelli L, Riontino E, Majore L, Ragona R, Bussi M (1999) Multi-center study of recurrent nasal sinus polyposis: prognostic factors and possibility of prophylaxis. Acta OtorhinolaryngolItal 19:315–324
12.
Zurück zum Zitat Ardehali MM, Amali A, Bakhshaee M, Madani Z, Amiri M (2009) The comparison of histopathological characteristics of polyps in asthmatic and nonasthmatic patients. Otolaryngol Head Neck Surg. 140:748–751CrossRefPubMed Ardehali MM, Amali A, Bakhshaee M, Madani Z, Amiri M (2009) The comparison of histopathological characteristics of polyps in asthmatic and nonasthmatic patients. Otolaryngol Head Neck Surg. 140:748–751CrossRefPubMed
13.
Zurück zum Zitat Lund VJ, Kennedy DW (1995) Quantification for staging sinusitis. The staging and therapy group. Ann Otol Rhinol Laryngol Suppl 167:17–21CrossRefPubMed Lund VJ, Kennedy DW (1995) Quantification for staging sinusitis. The staging and therapy group. Ann Otol Rhinol Laryngol Suppl 167:17–21CrossRefPubMed
14.
Zurück zum Zitat Lund VJ, Mackay IS (1993) Staging in rhinosinusitis. Rhinology 31:183–184PubMed Lund VJ, Mackay IS (1993) Staging in rhinosinusitis. Rhinology 31:183–184PubMed
15.
Zurück zum Zitat Hopkins C, Gillett S, Slack R et al (2009) Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 34:447–454CrossRefPubMed Hopkins C, Gillett S, Slack R et al (2009) Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 34:447–454CrossRefPubMed
16.
Zurück zum Zitat Glicklich R, Metson R (1995) The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg 113:104–109CrossRef Glicklich R, Metson R (1995) The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg 113:104–109CrossRef
17.
Zurück zum Zitat Yacoub MR, Trimarchi M, Cremona G et al (2015) Are atopy and eosinophilic bronchial inflammation associated with relapsing forms of chronic rhinosinusitis with nasal polyps? Clin Mol Allergy 13:23CrossRefPubMedPubMedCentral Yacoub MR, Trimarchi M, Cremona G et al (2015) Are atopy and eosinophilic bronchial inflammation associated with relapsing forms of chronic rhinosinusitis with nasal polyps? Clin Mol Allergy 13:23CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Ardehali MM, Amali A, Bakhshaee M, Madani Z (2011) Histopathologic characteristics of inferior turbinate vs ethmoidal polyp in chronic rhinosinusitis. Ann Diagn Pathol 15:233–236CrossRefPubMed Ardehali MM, Amali A, Bakhshaee M, Madani Z (2011) Histopathologic characteristics of inferior turbinate vs ethmoidal polyp in chronic rhinosinusitis. Ann Diagn Pathol 15:233–236CrossRefPubMed
19.
Zurück zum Zitat Brunner PJ, Jawad BA, McCoy ED (2017) Polypoid change of middle turbinate and paranasal sinus polyposis are distinct entities. Otolaryngol Head Neck Surg 157:519–523CrossRefPubMed Brunner PJ, Jawad BA, McCoy ED (2017) Polypoid change of middle turbinate and paranasal sinus polyposis are distinct entities. Otolaryngol Head Neck Surg 157:519–523CrossRefPubMed
20.
Zurück zum Zitat Hamizan AW, Christensen JM, Ebenzer J (2017) Middle turbinate edema as a diagnostic marker of inhalant allergy. Int Forum Allergy Rhinol 7:37–42CrossRefPubMed Hamizan AW, Christensen JM, Ebenzer J (2017) Middle turbinate edema as a diagnostic marker of inhalant allergy. Int Forum Allergy Rhinol 7:37–42CrossRefPubMed
21.
Zurück zum Zitat White LJ, Rotella MR, DelGaudio JM (2017) Polypoid changes of the middle turbinate as an indicator of atopic disease. Int Forum Allergy Rhinol. 4:376–380CrossRef White LJ, Rotella MR, DelGaudio JM (2017) Polypoid changes of the middle turbinate as an indicator of atopic disease. Int Forum Allergy Rhinol. 4:376–380CrossRef
22.
Zurück zum Zitat Benamara A, Nguyen DT, Bordanger N et al (2013) On the origin of nasal polyposis in the ethmoid sub-compartments. Clin Otolaryngol 38:402–406CrossRefPubMed Benamara A, Nguyen DT, Bordanger N et al (2013) On the origin of nasal polyposis in the ethmoid sub-compartments. Clin Otolaryngol 38:402–406CrossRefPubMed
Metadaten
Titel
Polypoid change of middle turbinate is associated to an increased risk of polyp recurrence after surgery in patients with chronic rhinosinusitis with nasal polyps
verfasst von
Amin Amali
Ziba Bidar
Sara Rahavi-Ezabadi
Narges Mikaniki
Seyed Mousa Sadrehosseini
Publikationsdatum
09.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 8/2018
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5032-2

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