Central compartment atopic disease: outcomes compared with other subtypes of chronic rhinosinusitis with nasal polyps

2021 ◽  
Author(s):  
Andrew J. Steehler ◽  
Jackson R. Vuncannon ◽  
Sarah K. Wise ◽  
John M. DelGaudio
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Central Compartment ◽  
Atopic Disease ◽  
Disease Outcomes

Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

2020 ◽  
Vol 34 (5) ◽  
pp. 610-617 ◽  
Author(s):  
Joseph S. Schertzer ◽  
Joshua M. Levy ◽  
Sarah K. Wise ◽  
Kelly R. Magliocca ◽  
John M. DelGaudio
Keyword(s):  
Allergic Rhinitis ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Benign Lesion ◽  
Retrospective Chart Review ◽  
Central Compartment ◽  
Atopic Disease ◽  
Sinus Surgery ◽  
Respiratory Epithelial Adenomatoid Hamartoma ◽  
Respiratory Epithelial

Background Respiratory epithelial adenomatoid hamartoma (REAH) is a benign lesion of the sinonasal tract that may mimic more concerning pathology. Clinical factors associated with REAH have not been well characterized. Objective To report our findings on patients with this pathologic diagnosis. Methods A retrospective chart review of patients with REAH between September 2006 and November 2019 was conducted. Data collected included clinical allergic rhinitis and asthma history, additional sinonasal diagnoses, prior sinus surgery, and the location of the REAH within the sinonasal cavity. Results Twenty-six patients were identified (53.8% male, mean age 62 years [range, 29–93]). Bilateral REAH occurred in 50%. REAH was located at the superior nasal septum in 84.6% cases, with the remainder identified in sinus contents submitted for pathology, making definitive site uncertain. Concurrent sinonasal inflammatory disorders were identified in 18 patients (69.2%), including chronic rhinosinusitis with nasal polyps—not otherwise specified (6), chronic rhinosinusitis without nasal polyps (4), aspirin-exacerbated respiratory disease (2), allergic fungal rhinosinusitis (1), central compartment atopic disease (5), and IgG4-related sclerosing disease (1). Eight patients had isolated REAH. Adequate allergy records were available for 19 patients, of which 18 of 19 (94.7%) had clinical allergic rhinitis. Conclusions REAH is a benign sinonasal lesion commonly located within the central compartment of the nasal cavity, a site of significant allergen exposure. Affected patients have a high incidence of allergy along with chronic inflammatory conditions. The coexistence of REAH within inflammatory nasal mucosa in a consistent anatomic location, suggests REAH may have a similar etiology to central compartment atopic disease, with resultant respiratory glandular ingrowth within long-standing reactive changes of mucosa derived from ethmoid embryologic origin.

scholarly journals Central compartment atopic disease: prevalence of allergy and asthma compared with other subtypes of chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 10 (2) ◽  
pp. 183-189 ◽  
Author(s):  
Sonya Marcus ◽  
Joseph Schertzer ◽  
Lauren T. Roland ◽  
Sarah K. Wise ◽  
Joshua M. Levy ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Central Compartment ◽  
Atopic Disease ◽  
Disease Prevalence ◽  
Allergy And Asthma

scholarly journals Chronic Rhinosinusitis: Does Allergy Play a Role?

2019 ◽  
Vol 7 (2) ◽  
pp. 30 ◽  
Author(s):  
Sonya Marcus ◽  
John M. DelGaudio ◽  
Lauren T. Roland ◽  
Sarah K. Wise
Keyword(s):  
Chronic Rhinosinusitis ◽  
Strong Association ◽  
Central Compartment ◽  
Atopic Disease ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
The Relationship

A few chronic rhinosinusitis (CRS) variants have demonstrated a strong association with environmental allergy, including allergic fungal rhinosinusitis (AFRS) and central compartment atopic disease (CCAD). However, the overall relationship between CRS and allergy remains poorly defined. The goal of this review is to evaluate the relationship between CRS and allergy with a focus on specific CRS variants.

Computed Tomography Findings Can Help Identify Different Chronic Rhinosinusitis With Nasal Polyp Phenotypes

2020 ◽  
Vol 34 (5) ◽  
pp. 679-685 ◽  
Author(s):  
Lauren T. Roland ◽  
Sonya Marcus ◽  
Joseph S. Schertzer ◽  
Sarah K. Wise ◽  
Joshua M. Levy ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chronic Rhinosinusitis ◽  
Middle Turbinate ◽  
Central Compartment ◽  
Atopic Disease ◽  
Patient Counseling ◽  
Not Otherwise Specified ◽  
Ct Findings ◽  
Preoperative Ct ◽  
Patient Groups

Background Chronic rhinosinusitis with nasal polyps (CRSwNPs) has several phenotypes. Objectives The goal of this study was to evaluate computed tomography (CT) findings associated with each CRSwNP phenotype. Methods Patient charts between January 2015 and March 2019 were retrospectively reviewed. Patient groups, including allergic fungal rhinosinusitis (AFRS), aspirin-exacerbated respiratory disease (AERD), central compartment atopic disease (CCAD) and CRSwNP not otherwise specified (CRSwNP NOS), were determined by standard criteria. The oldest CT scan available was reviewed for Lund–Mackay (LM) score, septal involvement of inflammatory disease, opacification of olfactory clefts, nasal cavity opacification, and oblique positioning of the middle turbinates. Nonparametric analyses of variance were performed with correction for multiple comparisons. Results A total of 356 patients had scans available for review; 80 (23%) patients were categorized into the AFRS group, 101 (28%) in the AERD group, 43 (12%) in the CCAD group, and 132 (37%) in the CRSwNP NOS group. Septal inflammatory involvement and oblique middle turbinate orientation on CT scans was higher in both AERD patients and CCAD patients as compared to AFRS and CRSwNP NOS patients ( P < .05). Olfactory cleft opacification was increased in the AERD group compared to all other diagnoses ( P < .05). The CCAD group showed lower LM scores compared to all other groups ( P < .05), and the AFRS group revealed the greatest differences between left and right LM grades, representing unilaterality of disease ( P < .05). Conclusion CRSwNP encompasses many subsets of disease, which have varying treatments and intraoperative findings. Preoperative CT findings can be used to differentiate between these groups to improve prediction of diagnoses and patient counseling.

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