Osteomeatal Complex Obstruction is not Associated with Adjacent Sinus Disease in Chronic Rhinosinusitis with Polyps

2011 ◽  
Vol 25 (6) ◽  
pp. 401-403 ◽  
Author(s):  
Randy M. Leung ◽  
Robert C. Kern ◽  
David B. Conley ◽  
Bruce K. Tan ◽  
Rakesh K. Chandra
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Disease Process ◽  
Subsequent Development ◽  
Ct Scans ◽  
Osteomeatal Complex ◽  
Maximal Medical Therapy ◽  
Previous Pilot Study

Background It is universally accepted that osteomeatal complex (OMC) disease is linked to the subsequent development of chronic rhinosinusitis without nasal polyps (CRSsNPs) via postobstructive mechanisms. The role of OMC obstruction in the pathogenesis of CRSwNPs is less clear. This study was designed to identify if there is an association between OMC obstruction and inflammation of the adjacent sinuses, when patients are stratified by polyp status. This is a follow-up and expanded series of a previous pilot study from our group. Method CT scans of 144 patients with CRSsNPs and 123 patients with CRS with nasal polyps (CRSwNPs) were evaluated for each sinus and OMC. Patients had no previous surgeries for NPs. CT scans were obtained after a trial of maximal medical therapy. Results Increasing OMC involvement was associated with increasing Lund-Mackay score for both CRSsNPs and CRSwNPs. In CRSsNP patients, OMC status significantly correlated with adjacent sinus status (p < 0.0001). Meanwhile in CRSwNPs, OMC status does not correlate with adjacent sinus status (p = 0.328). Conclusion OMC obstruction in the setting of CRSwNP may be a barometer of the overall disease process, but in this scenario, paranasal sinus inflammation can not be classified as a postobstructive phenomenon. These findings question the role of minimally invasive procedures in the management of CRSwNPs.

scholarly journals Factors Affecting the Control of Chronic Rhinosinusitis With Nasal Polyps: A Comparison in Patients With or Without NERD

2021 ◽  
Vol 12 ◽  
pp. 215265672110038
Author(s):  
Markus Jukka Lilja ◽  
Anni Koskinen ◽  
Paula Virkkula ◽  
Seija Inkeri Vento ◽  
Jyri Myller ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Female Gender ◽  
Sinus Surgery ◽  
Logrank Test ◽  
Free Survival ◽  
Factors Affecting ◽  
Advanced Therapy ◽  
And Gender

Objectives The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing: A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting Tertiary rhinology centers. Methods Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001–17 were studied. Mean follow-up time was 9.9 years (range 1.1–15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean ± SD of 4.3 ± 2.8 and 3.7 ± 2.6 years, respectively (p = .013, by Logrank test). In Cox´s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.

scholarly journals Let-7a-5p regulates the inflammatory response in chronic rhinosinusitis with nasal polyps

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianwei Zhang ◽  
Lei Han ◽  
Feng Chen
Keyword(s):  
Inflammatory Response ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Mapk Pathway ◽  
Inhibitory Effect ◽  
Luciferase Reporter ◽  
Western Blot Assay ◽  
Protein Levels ◽  
Tnf Α

Abstract Background Let-7a-5p is demonstrated to be a tumor inhibitor in nasopharyngeal carcinoma. However, the role of let-7a-5p in chronic rhinosinusitis with nasal polyps (CRSwNP) has not been reported. This study is designed to determine the pattern of expression and role of let-7a-5p in CRSwNP. Methods The expression level of let-7a-5p, TNF-α, IL-1β, and IL-6 in CRSwNP tissues and cells were detected by RT-qPCR. Western blot assay was carried out to measure the protein expression of the Ras-MAPK pathway. Dual luciferase reporter assay and RNA pull-down assay were used to explore the relationship between let-7a-5p and IL-6. Results Let-7a-5p was significantly downregulated in CRSwNP tissues and cells. Moreover, the mRNA expression of TNF-α, IL-1β and IL-6 was increased in CRSwNP tissues, while let-7a-5p mimic inhibited the expression of TNF-α, IL-1β and IL-6. Besides that, let-7a-5p was negatively correlated with TNF-α, IL-1β and IL-6 in CRSwNP tissues. In our study, IL-6 was found to be a target gene of let-7a-5p. Additionally, let-7-5p mimic obviously reduced the protein levels of Ras, p-Raf1, p-MEK1 and p-ERK1/2, while IL-6 overexpression destroyed the inhibitory effect of let-7a-5p on the Ras-MAPK pathway in CRSwNP. Conclusion We demonstrated that let-7a-5p/IL-6 interaction regulated the inflammatory response through the Ras-MAPK pathway in CRSwNP.

The role of exudation in chronic subdural hematomas

2007 ◽  
Vol 107 (2) ◽  
pp. 290-295 ◽  
Author(s):  
Mehmet Tokmak ◽  
A. Celal Iplikcioglu ◽  
Sirzat Bek ◽  
Cem Atilla Gökduman ◽  
Mustafa Erdal
Keyword(s):  
Outer Membrane ◽  
Clinical Status ◽  
Ct Scans ◽  
Subdural Hematomas ◽  
The Mean ◽  
Grade 3 ◽  
Age Range ◽  
Exudation Rate

Object Chronic subdural hematomas (SDHs) are a local inflammatory process that causes the formation of a granulation tissue often referred to as the external or outer membrane. This membrane has abnormally permeable macrocapillaries. Therefore, exudation from the macrocapillaries in the outer membrane of chronic SDH may play an important role in the enlargement of chronic SDH. In this study the authors investigated the role of exudation in chronic SDH. Methods The authors examined 24 patients (16 men and eight women; age range 38–86 years [mean age 61.4 years]) with 27 chronic SDHs. The clinical status of the patients was evaluated according to the classification described by Markwalder. The diagnosis was established on computed tomography (CT) scans in all cases. The authors also used the Nomura Classification for judging the lesion's appearance on CT scans. Immediately after the diagnosis, all patients were administered 20 mCi (740 mBq) technetium-99m human serum albumin. Four hours later, blood and SDH samples were taken and radioactivity levels were measured in each. The ratio of activity of the samples taken from chronic SDH to the radioactivity of blood was determined as a percentage and defined as the exudation rate. On the follow-up CT scan obtained on postoperative Day 20, subdural collections thicker than 5 mm were determined to be a reaccumulation. Results The correlations between the exudation rate and age of the patients, clinical grades, CT appearances, and amount of reaccumulation were investigated. In this series the average exudation rate was 13.24% (range 2.05–28.88%). The mean exudation rates according to the clinical grades assigned to patients were as follows: Grade 0, 8.67 ± 5.64% (three patients); Grade 1, 5.07 ± 1.43% (eight patients); Grade 2, 17.87 ± 3.73% (seven patients); and Grade 3, 19.65 ± 7.67% (six patients). Exudation rates in patients with Grades 2 and 3 were significantly higher than those in Grades 0 and 1 (p < 0.05). The mean exudation rates according to the lesion's appearance on CT scans were found as follows: hypodense appearance, 6.55 ± 4.52% (eight patients); isodense appearance, 11.07 ± 6.32% (five patients); hyperdense appearance, 19.47 ± 13.61% (three patients); and mixed-density appearance, 17.40 ± 5.80% (nine patients). The differences among the groups were significant (p < 0.05). The average exudation rate was statistically higher in the patients with reaccumulation (16.30 ± 8.16%) than that in the patients without reaccumulation (9.96 ± 6.84%) (p < 0.05). Conclusions The exudation rate in chronic SDH is correlated with a higher clinical grade (Markwalder Grade 2 or 3), mixed-density CT appearance, and reaccumulation. Therefore, exudation from macrocapillaries in the outer membrane of chronic SDH probably plays an important role in the pathophysiology and the growth of chronic SDH.

Role of the Aryl Hydrocarbon Receptor in the Pathogenesis of Chronic Rhinosinusitis with Nasal Polyps

Inflammation ◽  
2013 ◽  
Vol 37 (2) ◽  
pp. 387-395 ◽  
Author(s):  
Ping Wei ◽  
Guo-hua Hu ◽  
Hou-yong Kang ◽  
Hong-bing Yao ◽  
Wei Kou ◽  
...  
Keyword(s):  
Aryl Hydrocarbon Receptor ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Aryl Hydrocarbon

Endoscopic Management of Frontal Sinus Osteomas Revisited

2009 ◽  
Vol 23 (3) ◽  
pp. 331-336 ◽  
Author(s):  
Kristin Seiberling ◽  
Steve Floreani ◽  
Simon Robinson ◽  
Peter-John Wormald
Keyword(s):  
Endoscopic Resection ◽  
Frontal Sinus ◽  
Ct Scans ◽  
Endoscopic Management ◽  
Grading System ◽  
Tumor Removal ◽  
Successful Removal ◽  
Grade Iii

Background Recent articles have published guidelines regarding the role of endoscopic surgery in the removal of frontal sinus osteomas. These guidelines recommend the endoscopic approach for small osteomas but recommend an osteoplastic flap for larger tumors. This study presents a series of endoscopically resected tumors both large and small. Methods Retrospective chart reviews were performed. Charts were reviewed of all patients who underwent surgical resection of a frontal sinus osteoma from 1998 to 2008. Sinus CT scans were reviewed and each tumor was staged according to Kennedy's grading system proposed in 2005. Results Twenty-three patients, 8 with a grade IV tumor, 6 with a grade III tumor, and the remaining with a grade I or II tumor, underwent endoscopic resection of a frontal sinus osteoma. In 15 patients a modified Lothrop procedure was performed for tumor removal. In addition, a blepharoplasty incision was used in one patient for removal of a large orbital extension of the tumor and another underwent an enlarged frontal sinus trephine performed via a browline incision. In the remaining patients a frontal sinusotomy with minitrephination provided enough access for tumor removal. Over an average follow-up of 36 months no recurrences were noted. Symptoms improved in all but one patient. There were no postoperative complications. Conclusion Endoscopic resection of both large and small frontal sinus osteomas is feasible. In this article we have shown successful removal of large osteomas that fill the entire frontal sinus with the modified Lothrop procedure.

scholarly journals The Role of NF-κB in Chronic Rhinosinusitis With Nasal Polyps

2019 ◽  
Vol 11 (6) ◽  
pp. 806 ◽  
Author(s):  
Hahn Jin Jung ◽  
Yu-Lian Zhang ◽  
Dong-Kyu Kim ◽  
Chae-Seo Rhee ◽  
Dong-Young Kim
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps

scholarly journals Role of biomarkers in predicting the occurrence of thyroid neoplasms in radiation-exposed children

2018 ◽  
Vol 25 (4) ◽  
pp. 481-491
Author(s):  
Joseph M Shulan ◽  
Leonid Vydro ◽  
Arthur B Schneider ◽  
Dan V Mihailescu
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Nodules ◽  
Subsequent Development ◽  
Thyroid Neoplasms ◽  
Childhood Cancer Survivors ◽  
Malignant Neoplasms ◽  
Increased Risk ◽  
Need To Evaluate

With increasing numbers of childhood cancer survivors who were treated with radiation, there is a need to evaluate potential biomarkers that could signal an increased risk of developing thyroid cancer. We aimed to examine the relationships between thyrotropin and thyroglobulin levels and the risk of developing thyroid nodules and cancer in a cohort of radiation-exposed children. 764 subjects who were irradiated in the neck area as children were examined and followed for up to 25 years. All subjects underwent a clinical examination, measurements of thyrotropin, thyroglobulin levels and thyroid imaging. At baseline, 216 subjects had thyroid nodules and 548 did not. Of those with nodules, 176 underwent surgery with 55 confirmed thyroid cancers. During the follow-up, 147 subjects developed thyroid nodules including 22 with thyroid cancer. Thyroglobulin levels were higher in subjects with prevalent thyroid nodules (26.1 ng/mL vs 9.37 ng/mL; P < 0.001) and in those who had an initial normal examination but later developed thyroid nodules (11.2 ng/mL vs 8.87 ng/mL; P = 0.017). There was no relationship between baseline thyrotropin levels and the prevalent presence or absence of thyroid nodules, whether a prevalent neoplasm was benign or malignant, subsequent development of thyroid nodules during follow-up or whether an incident nodule was benign or malignant. In conclusion, in radiation-exposed children, higher thyroglobulin levels indicated an increased risk of developing thyroid nodules but did not differentiate between benign and malignant neoplasms. There was no association between the baseline TSH level and the risk of developing thyroid nodules or cancer.

Sign in / Sign up

Export Citation Format

Share Document