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Nasal polyposis

Jantina C de Groot, Huib Storm, Marijke Amelink, Selma B de Nijs, Edwin Eichhorn, Bennie H Reitsma, Elisabeth H D Bel, Anneke Ten Brinke
Adult-onset eosinophilic asthma is increasingly recognised as a severe and difficult-to-treat subtype of asthma. In clinical practice, early recognition of patients with this asthma subtype is important because it may have treatment implications. Therefore, physicians need to know the distinct characteristics of this asthma phenotype. The objective of the present study was to determine the characteristic profile of patients with adult-onset eosinophilic asthma. 130 patients with adult-onset (>18 years of age) asthma and high blood eosinophil counts (≥0...
April 2016: ERJ Open Research
Selahattin Tugrul, Remzi Dogan, Erol Senturk, Ilker Kocak, Seda Sezen, Mefkur Bakan, Orhan Ozturan
: OBJECTıVE: The objective of this randomized double blind study was to evaluate effect of the premedication with oral clonidine on blood pressure, cleaning of surgical site and bleeding in the ESS performed due to advanced NP. METHODS: A total of 52 patients who underwent functional endoscopic sinus surgery (FESS) due to Kennedy grade 4 nasal polyposis (NP) were included. Patients were randomized into two groups. Group 1 (n=26) received 0.2mg oral clonodine one hour before the operation in addition to standard anesthesia procedure...
August 30, 2016: American Journal of Otolaryngology
Andrew R Parker, Andrew G Ayars, Matthew C Altman, William R Henderson
Aspirin-exacerbated respiratory disease (AERD) is a syndrome of severe asthma and rhinosinusitis with nasal polyposis with exacerbations of baseline eosinophil-driven and mast cell-driven inflammation after nonsteroidal antiinflammatory drug ingestion. Although the underlying pathophysiology is poorly understood, dysregulation of the cyclooxygenase and 5-lipoxygenase pathways of arachidonic acid metabolism is thought to be key. Central features of AERD pathogenesis are overproduction of proinflammatory and bronchoconstrictor cysteinyl leukotrienes and prostaglandin (PG) D2 and inhibition of bronchoprotective and antiinflammatory PGE2...
November 2016: Immunology and Allergy Clinics of North America
Jeremy D Waldram, Ronald A Simon
Aspirin-exacerbated respiratory disease (AERD) is characterized by chronic rhinosinusitis with nasal polyps, asthma, and reactions to cyclooxygenase-1-inhibiting drugs. This condition is often refractory to standard medical treatments and results in aggressive nasal polyposis that often requires multiple sinus surgeries. Aspirin desensitization followed by daily aspirin therapy is an important treatment option, and its efficacy has been validated in multiple research studies. Aspirin desensitization is not without risk, but specific protocols and recommendations exist to mitigate the risk...
November 2016: Immunology and Allergy Clinics of North America
Federica Porcaro, Antonio Di Marco, Renato Cutrera
Aspirin hypersensitivity associated with chronic rhinosinusitis-with or without nasal polyposis-and asthma resistant to conventional therapy defines the aspirin-exacerbated respiratory disease (AERD). We describe the case of a 15-year-old female patient with adverse reaction to aspirin, chronic rhinosinusitis, and severe asthma. She also experienced chronic idiopathic urticaria worsened by non-steroidal anti-inflammatory drug administration. AERD was diagnosed based on clinical history and symptoms. Given the poor responsiveness to standard therapy for respiratory and cutaneous symptoms, omalizumab was administered for 24 weeks with control of respiratory symptoms and short term improvement of cutaneous symptoms...
September 29, 2016: Pediatric Pulmonology
Jessica Han Ying Tan, Anne Ann Ling Hsu
BACKGROUND: Patients with aspirin-exacerbated respiratory disease (AERD) also recently known as nonsteroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (NERD) must avoid aspirin and all other oral NSAIDs. The effect of topical NSAID (tNSAID), especially salicylates which are commonly present in topical medicated preparations, on asthma control of this phenotype is studied. METHODS: The study inclusion criteria were adults with: 1) NSAID hypersensitivity; 2) nasal polyposis/chronic rhinosinusitis; 3) not well-/poorly controlled asthma and 4) exposure to tNSAID...
September 2016: Respiratory Medicine
Preeti Kohli, Akash N Naik, Zachary Farhood, Adrian A Ong, Shaun A Nguyen, Zachary M Soler, Rodney J Schlosser
OBJECTIVE: To use combined pre- and postsurgical olfactory outcomes to assess the impact of endoscopic sinus surgery on chronic rhinosinusitis-related olfactory impairment. DATA SOURCES: CINAHL, Cochrane, OVID, EMBASE, PubMed, and SCOPUS. Each database was searched from inception up to October 2015. REVIEW METHODS: Studies were included that reported subjective or objective olfactory data in chronic rhinosinusitis patients before and after endoscopic sinus surgery...
August 30, 2016: Otolaryngology—Head and Neck Surgery
Katherine N Cahill, Christina B Johns, Jing Cui, Paige Wickner, David W Bates, Tanya M Laidlaw, Patrick E Beeler
BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) is characterized by 3 clinical features: asthma, nasal polyposis, and respiratory reactions to cyclooxygenase-1 inhibitors (nonsteroidal anti-inflammatory drugs). Electronic health records (EHRs) contain information on each feature of this triad. OBJECTIVE: We sought to determine whether an informatics algorithm applied to the EHR could electronically identify patients with AERD. METHODS: We developed an informatics algorithm to search the EHRs of patients aged 18 years and older from the Partners Healthcare system over a 10-year period (2004-2014)...
July 25, 2016: Journal of Allergy and Clinical Immunology
Nathalia Velasquez, Andrew Thamboo, Al-Rahim R Habib, Zhenxiao Huang, Jayakar V Nayak
BACKGROUND: Empty nose syndrome (ENS) is considered an acquired condition that remains difficult to diagnose objectively. Defining specific symptoms that can be reliably associated with this disorder would be essential to identifying possible ENS patients. We sought to validate an ENS-specific, 6-item questionnaire as an adjunct to the standard Sino-Nasal Outcome Test 22 (SNOT-22) questionnaire to discriminate patients suspected of having ENS. METHODS: The Empty Nose Syndrome 6-item Questionnaire (ENS6Q) paired 6 common ENS symptoms (nasal suffocation, nasal burning, nasal openness, crusting, dryness, and impaired air sensation through nasal cavities) with testing on 75 patients divided in 3 patient cohorts: ENS; chronic rhinosinusitis without polyposis; and healthy controls...
August 24, 2016: International Forum of Allergy & Rhinology
Marcin Fraczek, Maciej Guzinski, Monika Morawska-Kochman, Tomasz Krecicki
The aim of the study was to compare visualisation of the surgically relevant anatomical structures via low- and standard-dose multidetector CT protocol in patients with chronic rhinosinusitis (CRS) and higher risk for perioperative complications (i.e. presence of bronchial asthma, history of sinus surgery and advanced nasal polyposis). 135 adult CRS patients were divided randomly into standard-dose (120 kVp, 100 mAs) or low-dose CT groups (120 kVp, 45 mAs). The detectability of the vital anatomical structures (anterior ethmoid artery, optic nerve, cribriform plate and lamina papyracea) was scored using a five-point scale (from excellent to unacceptable) by a radiologist and sinus surgeon...
August 23, 2016: European Archives of Oto-rhino-laryngology
Davut Akduman, Mehmet Haksever, Muhammed Yanilmaz, Fevzi Solmaz
Mulberry hypertrophy occasionally coexists with sinonasal pathologies. There are very few reports in the literature on this clinical entity. We conducted a retrospective study to draw attention to this condition in the context of accompanying sinonasal pathologies. Our study group was made up of 68 patients-51 males and 17 females, aged 13 to 57 years (mean: 34.9)-who had been diagnosed with mulberry hypertrophy and at least one accompanying sinonasal pathology. All patients had a long-standing chronic discharge...
August 2016: Ear, Nose, & Throat Journal
Emine Güven Sakalar, Nuray Bayar Muluk, Murat Kar, Cemal Cingi
Aspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients...
August 18, 2016: European Archives of Oto-rhino-laryngology
Yolande Asara, Andrea Melis, Laura Maria De Luca, Corrado Bozzo, Paolo Castiglia, Giannina Chessa, Patrizia Piras, Apostolos Karligkiotis, Pasquale Bandiera, Michele Malaguarnera, Juan Antonio Marchal, Roberto Madeddu
Metals have strong toxic effects in humans and can act as immunoregulatory factors. The purpose of our study was to determine whether the concentrations of metals are associated with the clinical course of nasal polyposis (NP). We measured the concentrations of 10 metals and non-metal (Zn, Mn, Se, Fe, Cr, Ni, Pb, Al, Cd, and Cu) in 58 patients with NP, and 29 controls with a healthy nasal mucosa. We used electron microscopy to compare the ultrastructural features of the nasal mucosa between NP patients and healthy controls...
August 13, 2016: Environmental Science and Pollution Research International
M Soledad Cabrera-Ramírez, M Sandra Domínguez-Sosa, Silvia Andrea Borkoski-Barreiro, Juan Carlos Falcón-González, Ángel Ramos-Macías
INTRODUCTION AND OBJECTIVES: Endoscopic sinus surgery is currently the surgical procedure chosen in cases of sinonasal polyposis refractory to medical treatment. The aim of this study was to show our experience in managing such patients operated using endoscopic sinus surgery. METHOD: A retrospective study of 246 patients with chronic rhinosinusitis and nasal polyps who were operated by endoscopic surgery. We studied the characteristics of the population, symptoms, grade of affectation, complications and recurrences...
August 8, 2016: Acta Otorrinolaringológica Española
Abdulvahap Akyigit, Erol Keles, Ebru Onalan Etem, Ibrahim Ozercan, Hatice Akyol, Oner Sakallioglu, Turgut Karlidag, Cahit Polat, Irfan Kaygusuz, Sinasi Yalcin
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the paranasal sinuses, and its pathophysiology is not yet precisely known. It is suggested that oxygen free radicals play an important role in the pathogenesis of nasal polyposis. This study aimed to identify genetic polymorphisms of superoxide dismutase (SOD 2), catalase (CAT), and inducible nitric oxide synthase (iNOS) enzymes in eosinophilic CRSwNP and non-eosinophilic CRSwNP patients; the study also aimed to evaluate the effect of genetic polymorphism of antioxidant enzymes on CRSwNP etiopathogenesis...
August 11, 2016: European Archives of Oto-rhino-laryngology
Mücahide Esra Koçoğlu, Fırat Zafer Mengeloğlu, Tayfun Apuhan, Şeyda Özsoy, Beyhan Yilmaz
BACKGROUND/AIM: The aim of this study was to investigate the etiological role of human papilloma virus (HPV), herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpes virus-6 (HHV-6) and -7 (HHV-7) in the occurrence of nasal polyposis. MATERIALS AND METHODS: Nasal polyp samples from 30 patients with nasal polyposis and normal nasal mucosa from 10 patients without nasal polyps were obtained. DNA was extracted from tissues...
2016: Turkish Journal of Medical Sciences
R Jankowski, C Perrot, D T Nguyen, C Rumeau
CONTEXT: According to evo-devo theory, the embryonic development of the nasal organ mimics its phylontogenic formation: the lateral masses of the human ethmoid bone develop by curved "onion" stacking of the endoturbinals (the horizontal bone septa of the mammalian olfactory chamber) under the impact of facial and skull-base remodeling, rather than by pneumatization of cavities communicating via ostia. OBJECTIVES: To assess the frequency of the onion structure on coronal CT...
August 5, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Safinaz Karabayirli, Kadriye Serife Ugur, Ruveyda Irem Demircioglu, Bunyamin Muslu, Burhanettin Usta, Huseyin Sert, Nebil Ark
To compare dexmedetomidine with remifentanil in functional endoscopic sinus surgery (FESS) in regards to intra-operative bleeding, anesthetic consumption and post-operative recovery. Randomized, double blind study. Tertiary care medical center. Fifty patients with nasal polyposis who had been scheduled for FESS were randomly divided into two groups. In group D (n = 25), dexmedetomidine 1 µg/kg infused intravenous (IV) over 10 min before anesthesia induction, followed by a continuous of 0.7 µg/kg/h infusion during operation...
July 28, 2016: European Archives of Oto-rhino-laryngology
Jessica E Southwood, Todd A Loehrl, David M Poetker
In the standard functional endoscopic sinus surgery (FESS) procedure, the amount of dissection is often determined by the extent of disease with the goal to preserve as much normal mucosa as possible while restoring ventilation and reestablishing mucociliary clearance. A subset of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP), however, may continue to have persistent mucosal inflammatory and aggressive polyp regrowth despite standard FESS and maximal pharmacology therapy, leading to recurrent and recalcitrant disease...
2016: Advances in Oto-rhino-laryngology
Andrew J Thomas, Jeremiah A Alt
Oral therapeutics for chronic rhinosinusitis with nasal polyps (CRSwNP) include oral corticosteroids (OCS), antibiotics, antifungals and anti-leukotrienes. Of these treatments, the strongest evidence exists to support the use of a short course of OCS for treatment of CRSwNP, and OCS are the most consistently recommended oral therapy in practice guidelines. Antibiotics have demonstrated some utility, which appears more likely related to an anti-inflammatory rather than antimicrobial effect. The non-macrolide antibiotics lack sufficient evidence to support their use, though among this class doxycycline has some limited evidence of benefit in CRSwNP...
2016: Advances in Oto-rhino-laryngology
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