ORTA ANADOLU'DA KRONİK RİNOSİNÜZİTİN BİREYSEL ÖZELLİKLER VE ÇEVRESEL FAKTÖRLERLE İLİŞKİSİ

Yıl 2021, Cilt: 22 Sayı: 3, 178 - 184, 17.05.2021

Zeynep Erhuner Tengirşenk , Uğur Toprak , Müge Özcan

https://doi.org/10.18229/kocatepetip.707246

Öz

AMAÇ: Bu çalışmanın amacı, nazal polipli veya polipsiz kronik rinosinüzit (KRS) nedeni ile paranazal sinüs bilgisayarlı tomografisi (BT) yapılan hastalarda sinonazal hastalıkların prevalansını ve dağılımını araştırmak; KRS ile sinonazal varyasyonlar arasındaki ilişkiyi ve çevresel faktörlerin etkisini araştırmaktır.
GEREÇ VE YÖNTEM: Ankara'da üçüncü basamak sağlık merkezine başvuran 1000 hastanın paranazal sinüs BT görüntüleri ve dosyaları retrospektif olarak incelendi. BT bulguları, sigara içme durumu, allerji varlığı, ikamet yeri (kentsel/kırsal) ve fonksiyonel endoskopik sinüs cerrahisi öyküsü kaydedildi.
BULGULAR: En sık maksiller sinüslerde (%53) olmak üzere, hastaların %68’inde KRS tespit edildi. KRS'li nazal polipler olguların %11'inde kaydedildi. KRS ayrıca sigara içenler arasında daha yaygındı (p<0.001). Nazal poliplerin eşlik ettiği KRS açısından kentsel ve kırsal yerleşimli olanlar arasında fark bulunmadı. Bununla birlikte, nazal polipli KRS olgularının çoğu kentlerde yaşamaktadır (%81.4, p=0.006). Allerji ile nazal polipozis veya polipli KRS arasında; sinonazal varyasyonlar ile KRS gelişimi arasında fark saptanmadı.
SONUÇ: İncelenen bölgede, nazal polipli KRS prevalansı kentsel yerleşimde (hava kirliliği olan) daha yüksek iken, nazal polipsiz KRS bölgesel farklılık göstermemektedir. Sigara içenlerde KRS daha yaygındı ancak, nazal polipozisin eşlik ettiği KRS daha yaygın değildir. KRS, allerjik kişilerde daha yaygın değildir.

Anahtar Kelimeler

kronik sinüzit, bilgisayarlı tomografi, epidemiyoloji, hava kirliligi, sigara içme, allerjik rinit

RELATIONSHIP OF CHRONIC RHINOSINUSITIS WITH INDIVIDUAL CHARACTERISTICS AND ENVIRONMENTAL FACTORS IN CENTRAL ANATOLIA

Öz

OBJECTIVE: The aims of this study were to investigate the prevalence and distribution of sinonasal diseases in patients that underwent paranasal sinus computed tomography (CT) due to chronic rhinosinusitis (CRS) with or without nasal polyps, and to explore the association between CRS and sinonasal variations and the effect of environmental factors.
MATERIAL AND METHODS: The paranasal sinus CT images and files of 1000 patients that referred to a tertiary health center in Ankara were retrospectively evaluated. The CT findings, smoking status, presence of allergies, place of residence (urban/rural), and history of functional endoscopic sinus surgery were noted.
RESULTS: CRS was seen in 68% of the patients, and most common in maxillary sinuses (53%). Nasal polyps with CRS were noted in 11% of the cases. CRS was also more common among smokers (p<0.001). In CRS accompanied by nasal polyps, no difference was found between urban and rural residence. However, most cases of CRS with nasal polyps lived in urban areas (81.4%, p=0.006). There was no difference between allergy and CRS with and without nasal polyps or between sinonasal variations and CRS development.
CONCLUSIONS: In the region investigated, the prevalence of CRS with nasal polyps was higher in the urban area (higher air pollution); however, the prevalence of CRS without nasal polyps did not change according to the place of residence. CRS was generally more common among smokers, but there was no significant difference in patients with CRS accompanied by nasal polyps. CRS was not more common in people with allergies.

Anahtar Kelimeler

chronic sinusitis, computed tomography, epidemiology, air pullution, smoking, allergic rhinitis

Kaynakça

• 1. Juan F, Ayiheng Q, Yuqin F, Hua Z, Jun Y, Bin H. Risk Factors of Chronic Rhinosinusitis After Functional Endoscopic Sinus Surgery. Med Sci Monit 2017;23:1064-1068.
• 2. Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe--an underestimated disease. A GA²LEN study. Allergy 2011; 66:1216-23.
• 3. Hirsch AG, Stewart WF, Sundaresan AS, et al. Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy 2017; 72:274-281.
• 4. Klossek JM, Neukirch F, Pribil C, et al. Prevalence of nasal polyposis in France: a cross-sectional, case-control study. Allergy 2005; 60:233-7.
• 5. Hedman J, Kaprio J, Poussa T, Nieminen MM. Prevalence of asthma, aspirin intolerance, nasal polyposis and chronic obstructive pulmonary disease in a population-based study. Int J Epidemiol 1999; 28:717-22.
• 6. Settipane GA, Chafee FH. Nasal polyps in asthma and rhinitis.A review of 6,037 patients. J Allergy ClinImmunol 1977; 59:17-21.
• 7. Mady LJ, Schwarzbach HL, Moore JA, et.al RM, TJ, SE. Air pollutants may be environmental risk factors in chronic rhinosinusitis disease progression. Int Forum Allergy Rhinol 2018:8(3);377-384.
• 8. Hamilos DL. Chronic rhinosinusitis: epidemiology and medical management. J Allergy ClinImmunol 2011; 128:693-707.
• 9. Zhang Y, Gevaert E, Lou H, et al. Chronic rhinosinusitisin Asia. J Allergy ClinImmunol 2017; 140:1230-1239.
• 10. Pruna X. Morpho-functional evaluation of ostiomeatal complex in chronic sinusitis by coronal CT. EurRadiol 2003; 13:1461-1468.
• 11. Ross K, Chmiel JF, Ferkol T. The impact of the Clean Air Act. J Pediatr 2012;161:781–786.
• 12. Bhattacharyya N. Contemporary assessment of the disease burden of sinusitis. Am J Rhinol Allergy 2009;23:392-395.
• 13. Alexiou A, Sourtzi P, Dimakopoulou K, Manolis E, Velonakis E. Nasal polyps:heredity, allergies, and environmental and occupational exposure. J Otolaryngol Head Neck Surg 2011; 40:58-63.
• 14. Min YG, Jung HW, Kim HS, Park SK, Yoo KY. Prevalence and risk factors for perennial allergic rhinitis in Korea: results of a nationwide survey. ClinOtolaryngol Allied Sci 1997; 22:139-144.
• 15. Robinson S, Douglas R, Wormald PJ. The relationship between atopy and chronic rhinosinusitis. Am J Rhinol 2006; 20:625-8.
• 16. Newman LJ, Platts-Mills TA, Phillips CD, Hazen KC, Gross CW. Chronic sinusitis. Relationship of computed tomographic findings to allergy, asthma, and eosinophilia. JAMA 1994; 271:363-367.
• 17. Houser SM, Keen KJ. The role of allergy and smoking in chronic rhinosinusitis and polyposis. Laryngoscope 2008; 118:1521-1527.
• 18. Toledano Muñoz A, HerráizPuchol C, NavasMolinero C, GarcíaSimal M, Navarro Cunchillos M, Galindo Campillo AN. Epidemiological study in patients with nasal polyposis. Acta Otorrinolaringol Esp 2008; 59:(9): 438-43.
• 19. Mygind N, Dahl R, Bachert C. Nasal polyposis, eosinophil dominated inflammation, and allergy. Thorax 2000; 55:79–83.
• 20. Larsen PL, Tos M. Anatomic site of origin of nasal polyps. Am J Rhinol 1996;10:211–216.
• 21. Soler ZM, Sauer DA, Mace J, Smith TL. Relationship between clinical measures and histopathologic findings in chronic rhinosinusitis. Otolaryngol Head Neck Surg 2009; 141:454-461.
• 22. Karaman M, Tek A. Deleterious effect of smoking and nasal septal deviation on mucociliary clearance and improvement after septoplasty. Am J Rhinol Allergy 2009;23:2-7.
• 23. Briggs RD, Wright ST, Cordes S, Calhoun KH. Smoking in chronic rhinosinusitis: a predictor of poor long-term outcome after endoscopic sinus surgery. Laryngoscope 2004;114:126-128.
• 24. Lieu JE, Feinstein AR. Confirmations and surprises in the association of tobacco use with sinusitis. Arch Otolaryngol Head Neck Surg 2000;126:940-946.
• 25. Reh DD, Lin SY, Clipp SL, Irani L, Alberg AJ, Navas-Acien A. Secondhand tobacco smoke exposure and chronic rhinosinusitis: a population-based case-control study.Am J Rhinol Allergy 2009;23:562-567.
• 26. Sultész M, Csakanyi Z, Majoros T, Farkas Z, Katona G. Acute bacterial rhinosinusitis and its complications in our pediatric otolaryngological department between 1997 and 2006. Int J Pediatr Otorhinolaryngol 2009; 73:(11);1507-15012.
• 27. Danese M, Duvoisin B, Agrifoglio A, Cherpillod J, Krayenbuhl M. Influence of naso-sinusal anatomic variants on recurrent, persistent or chronic sinusitis. X-ray computed tomographic evaluation in 112 patients. J Radiol 1997;78:651-657.
• 28. Al-Qudah M. The relationship between anatomical variations of the sino-nasal region and chronic sinusitis extension in children.Int J Pediatr Otorhinolaryngol 2008;72:817-821.
• 29. Paşaoğlu L, Toprak U, Üstüner E, et al. Are Variations of Paranasal Sinuses and Infundibular Trace Length Responsible for Development of Maxillary Sinusitis? OMICS J Radiol 2017;6: 270. doi: 10.4172/2167- 7964.1000270.
• 30. Mfuna-Endam L, Zhang Y, Desrosiers MY. Genetics of rhinosinusitis. Curr Allergy Asthma Rep 2011;11:236-246.
• 31. Bachert C, Pawankar R, Zhang L, Bunnag C, Fokkens WJ, Hamilos DL, et al. ICON: chronic rhinosinusitis. World Allergy Organ J 2014;7:25.
• 32. Wang X, Zheng M, Lou H, Wang C, Zhang Y, Bo M, et al. An increased preva- lence of self-reported allergic rhinitis in major Chinese cities from 2005 to 2011. Allergy 2016;71:1170-1180.
• 33. Maher B. Personal genomes: the case of the missing heritability. Nature 2008; 456:18-21.
• 34. Zhang N, Holtappels G, Claeys C, Huang GQ, van Cauwenberge P, Bachert C. Pattern of inflammation and impact of Staphylococcus aureus enterotoxins in nasal polyposis from South of China. Am J Rhinol 2006;20:445-450.