The Effect of Eosinophilia Levels on the Radiological Severity of the Disease in Patients with a Nasal Polyp
Abstract
Objective: In recent years, a different subtype, characterized by eosinophilia infiltration that is associated with T-helper cell type 2 (Th2) inflammation is known to worsen disease prognosis in patients with a nasal polyp. We aimed to assess the correlation of serum and tissue eosinophil levels and the radiological severity of the disease in our own patient group.
Material and Methods: Total 201 patients, including 131 men and 70 women who had undergone endoscopic sinus surgery for nasal polyp from 2013 to 2017 at the Aydın Adnan Menderes University Hospital were enrolled in our study. The eosinophil rates in the preoperative whole blood hemogram examinations and the rates of eosinophils in surgical pathologies were compared; the paranasal sinus computed tomography (CT) sections were evaluated as per the Lund-Mackey score and Kennedy osteitis score (KOS). Osteitis was scored radiologically as per the KOS systems. As per the tissue eosinophil count, more patients had an eosinophil count >10 eosinophil count/HPF (large magnification; 400×) and fewer had eosinophil count ≤10 eosinophil/HPF count.
Results: The Lund-Mackey scores were significantly higher in those with high eosinophil levels in the pathological specimens. The KOS were also found to be high in patients with high Lund-Mackey scores. In patients with higher eosinophil levels in the blood sample, the tissue eosinophil value in pathology samples was also high.
Conclusion: In patients with eosinophilia in the tissue or blood, the radiological prevalence and the osteitis scores of chronic sinusitis are expected to be high.
Keywords
References
- Günel C, Yükselen OO, Başak HS, Eryilmaz A, Başal Y. Chronic rhinosinusitis; histopathologic study of osteitis in surgery cases. B-ENT 2015; 11: 135-9.
- Cho SW, Kim DW, Kim JW, Lee CH, Rhee CS. Classification of chronic rhinosinusitis according to a nasal polyp and tissue eosinophilia: Limitation of current classification system for Asian population. Asia Pac Allergy 2017; 7: 121-30.
- Tosun F, Arslan HH, Karslioglu Y, Deveci MS, Durmaz A. Relationship between postoperative recurrence rate and eosinophil density of nasal polyps. Ann Otol Rhinol Laryngol 2010; 119: 455-9.
- Bachert C, Akdis CA. Phenotypes and emerging endotypes of chronic rhinosinusitis. J Allergy Clin Immunol Pract 2016; 4: 621-8.
- Snidvongs K, McLachlan R, Sacks R, Earls P, Harvey RJ. Correlation of the Kennedy osteitis score to clinico-histologic features of chronic rhinosinusitis. Int Forum Allergy Rhinol 2013; 3: 369-75.
- Bhandarkar ND, Mace JC, Smith TL. The impact of osteitis on disease severity measures and quality of life outcomes in chronic rhinosinusitis. Int Forum Allergy Rhinol 2011; 1: 372-8.
- Soler ZM, Sauer D, Mace J, Smith TL. Impact of mucosal eosinophilia and nasal polyposis on quality-of-life outcomes after sinus surgery. Otolaryngol Head Neck Surg 2010; 142: 64-71.
- Snidvongs K, Lam M, Sacks R, Earls P, Kalish L, Phillips PS, et al. Structured histopathology profiling of chronic rhinosinusitis in routine practice. Int Forum Allergy Rhinol 2012; 2: 376-85.
- Nakayama T, Yoshikawa M, Asaka D, Okushi T, Matsuwaki Y, Otori N, et al. Mucosal eosinophilia and recurrence of nasal polyps - new classification of chronic rhinosinusitis. Rhinology 2011; 49: 392-6.
- Perloff JR, Gannon FH, Bolger WE, Montone KT, Orlandi R, Kennedy DW. Bone involvement in sinusitis: An apparent pathway for the spread of disease. Laryngoscope 2000; 110: 2095-9.
- Westrin KM, Norlander T, Stierna P, Carlsöö B, Nord CE. Experimental maxillary sinusitis induced by Bacteroides fragilis. A bacteriological and histological study in rabbits. Acta Otolaryngol 1992; 112: 107-14.
- Berry M, Morgan A, Shaw DE, Parker D, Green R, Brightling C, et al. Pathological features and inhaled corticosteroid response of eosinophilic and non-eosino-philic asthma. Thorax 2007; 62: 1043-9.
- Brain DJ. Historical background. Settipane GA, Lund VJ, Bernstein J, Tos M, editors. Nazal Polyps: Epidemiology, Pathogenesis and Treatment. Rhode Island: Ocean Side Publications; 1997.p.7-15.
- Hoover GE, Newman LJ, Platts-Mills TA, Phillips CD, Gross CW, Wheatley LM. Chronic sinusitis: Risk factors for extensive disease. J Allergy Clin Immunol 1997; 100: 185-91.
- Payne SC, Early SB, Huyett P, Han JK, Borish L, Steinke JW. Evidence for distinct histologic profile of nasal polyps with and without eosinophilia. Laryngoscope 2011; 121: 2262-7.
- Aslan F, Altun E, Paksoy S, Turan G. Could Eosinophilia predict clinical severity in nasal polyps?. Multidiscip Respir Med 2017; 12: 21.
- Ten Brinke A, Grootendorst DC, Schmidt JT, De Bruïne FT, van Buchem MA, Sterk PJ, et al. Chronic sinusitis in severe asthma is related to sputum eosinophilia. J Allergy Clin Immunol 2002; 109: 621-6.
- Kountakis SE, Arango P, Bradley D, Wade ZK, Borish L. Molecular and cellular staging for the severity of chronic rhinosinusitis. Laryngoscope 2004; 114: 1895-905.
Details
| Primary Language | English |
|---|---|
| Subjects | Otorhinolaryngology |
| Journal Section | Original Article |
| Authors | |
| Publication Date | August 1, 2020 |
| Published in Issue | Year 2020 Volume: 3 Issue: 2 |
Cite
You can find the current version of the Instructions to Authors at: https://www.eurjrhinol.org/en/instructions-to-authors-104
Starting on 2020, all content published in the journal is licensed under the Creative Commons Attribution-NonCommercial (CC BY-NC) 4.0 International
License which allows third parties to use the content for non-commercial purposes as long as they give credit to the original work. This license
allows for the content to be shared and adapted for non-commercial purposes, promoting the dissemination and use of the research published in
the journal.
The content published before 2020 was licensed under a traditional copyright, but the archive is still available for free access.