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Nasal polyps management

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https://www.readbyqxmd.com/read/29100865/clinical-phenotypes-of-nasal-polyps-and-comorbid-asthma-based-on-cluster-analysis-of-disease-history
#1
Dawei Wu, Benjamin S Bleier, Lun Li, Xiaojun Zhan, Lichuan Zhang, Qianwen Lv, Jianting Wang, Yongxiang Wei
BACKGROUND: Nasal polyps and comorbid asthma (NPcA) is a common united airway disease and is highly heterogeneous with respect to clinical, physiologic, and pathologic parameters. The clinical phenotypes of NPcA are poorly understood. OBJECTIVE: We sought to explore clinical phenotypes in patients with NPcA. METHODS: Patients first diagnosed with NPcA were recruited from Rhinological Clinics and Respiratory Clinics. We clustered patients with NPcA based on parameters regarding natural courses and demographic characteristics...
October 31, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29072882/rita-the-italian-severe-uncontrolled-asthma-registry
#2
Sara Maio, Sandra Baldacci, Megon Bresciani, Marzia Simoni, Manuela Latorre, Nicola Murgia, Fabrizio Spinozzi, Mariachiara Braschi, Leonardo Antonicelli, Barbara Brunetto, Patrizia Iacovacci, Paolo Roazzi, Carlo Pini, Mario Pata, Lidia La Grasta, Pierluigi Paggiaro, Giovanni Viegi
BACKGROUND: The Italian severe/uncontrolled asthma (SUA) web-based registry encompasses demographic, clinical, functional, inflammatory data; it aims to raise SUA awareness, identifying specific phenotypes and promoting optimal care. METHODS: 493 adult patients from 27 Italian centres (recruited in 2011-2014) were analyzed. RESULTS: Mean age was 53.8yrs. SUA patients were more frequently female (60.6%), with allergic asthma (83.1%). About 30% showed late onset of asthma diagnosis/symptoms (>40yrs); the mean age for asthma symptoms onset was 30...
October 26, 2017: Allergy
https://www.readbyqxmd.com/read/29072668/-polypous-pansinusitis-with-the-deformation-of-the-external-nose-in-a-8-year-old-child-presenting-with-the-primary-ciliary-dyskinesia-syndrome
#3
A I Asmanov, N V Zlobina, E Yu Radtsig, G A Polev, E V Sorokina
This article reports a rare observation of the development of chronic polypous pansinusitis with deformation of the external nose in a 8 year-old child presenting with primary ciliary dyskinesia syndrome. The patient underwent multiple surgical interventions in the preceding period. The key argument in favour of the definitive diagnosis was the results of investigation of ciliated epithelium biopsy taken from the nasal cavity and bronchi in combination with the data obtained by diagnostic endoscopy of the nasal cavity and nasopharynx supplemented by computed tomography...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/29059082/risks-and-management-of-long-term-corticosteroid-use-in-chronic-rhinosinusitis
#4
Raewyn G Campbell
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the use and risks of long-term corticosteroids in the management of chronic rhinosinusitis (CRS). RECENT FINDINGS: Long-term use of systemic corticosteroids is not indicated in the management of CRS due to the associated side effects and potential complications. Therefore, recent research has focused on the safety and efficacy of topical corticosteroid, particularly second-generation corticosteroids, and their modes of administration...
October 20, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29055085/current-use-of-baseline-medical-treatment-in-chronic-rhinosinusitis-data-from-the-national-chronic-rhinosinusitis-epidemiology-study-cres
#5
Carl Philpott, Sally Erskine, Rupert Smith, Claire Hopkins, Naveed Kara, Amir Farboud, Mahmoud Salam, Alasdair Robertson, Rob Almeyda, B Nirmal Kumar, Shahram Anari, Jaydip Ray, Russell Cathcart, Sean Carrie, Shahzada Ahmed, Hisham Khalil, Allan Clark, Mike Thomas
OBJECTIVES: According to clinical and comissioning guidelines for chronic rhinosinusitis (CRS), patients being referred to secondary care should have failed primary medical treatment with nasal douching (ND) and intranasal corticosteroids (INCS). The study objectives were to identify the rate of specific medical therapy in CRS patients and establish any differences in medication use, for both CRS and associated medical conditions, between CRS phenotypes. DESIGN AND SETTING: Case-control study in a secondary care setting...
October 20, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28966466/congenital-midline-nasal-anomalies
#6
Niraj Vora, Ram Kalagiri, Bryan Guillory, Ashita Shetty, Venkata Nakta Raju, R K Powitzky, Madhava R Beeram
Congenital midline nasal anomalies are rare, with a prevalence of 1 in 20,000 to 40,000 births and with 5% to 7% of them being nasal glioma. Differential diagnoses of nasal anomalies include nasal dermoid cysts, gliomas, encephaloceles, nasal polyps, and some other rare anomalies. Due to current medical technological advancements, most of these anomalies are easily correctable, though delaying management may lead to fatal effects. This report describes two cases-one of nasal glioma and one of nevus lipomatosus cutaneous superficialis-that presented as respiratory distress in a newborn...
October 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28873286/the-impact-of-asthma-on-the-cost-effectiveness-of-surgery-for-chronic-rhinosinusitis-with-nasal-polyps
#7
George A Scangas, Aaron K Remenschneider, Brooke M Su, Mark G Shrime, Ralph Metson
BACKGROUND: The objective of this work was to evaluate the impact of asthma on the cost-effectiveness profile of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: The study design consisted of a cohort-style Markov decision-tree cost utility analysis with a 35-year time horizon. Matched cohorts of CRSwNP patients with (n = 95) and without (n = 95) asthma who underwent ESS were compared with cohorts of patients from the national Medical Expenditures Survey Panel (MEPS) database who underwent medical management for chronic rhinosinusitis (CRS)...
September 5, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28815611/the-value-of-frontal-sinusotomy-for-chronic-rhinosinusitis-with-nasal-polyps-a-cost-utility-analysis
#8
George A Scangas, Ashton E Lehmann, Aaron K Remenschneider, Brooke M Su, Mark G Shrime, Ralph Metson
OBJECTIVES/HYPOTHESIS: The number of surgical procedures performed for frontal sinusitis and the associated costs have increased dramatically over the past decade. The purpose of this study was to evaluate the cost-effectiveness of endoscopic frontal sinusotomy (EFS) in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). STUDY DESIGN: Cohort-style Markov decision-tree economic model with a 36-year time horizon. METHODS: Matched cohorts of CRSwNP patients who underwent endoscopic sinus surgery (ESS) with (n = 139) and without (n = 49) EFS were compared to each other and to patients (n = 139) from the Medical Expenditures Survey Panel database who underwent medical management for chronic rhinosinusitis...
August 16, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28770480/how-to-assess-control-and-manage-uncontrolled-crs-nasal-polyp-patients
#9
REVIEW
Rahuram Sivasubramaniam, Richard J Harvey
PURPOSE OF REVIEW: Chronic rhinosinusitis (CRS) is a multidimensional inflammatory disorder of the nose and paranasal sinuses. We reviewed the recent literature to identify improved methods to assess, control, and manage these difficult to control patients. RECENT FINDINGS: The role of endotyping in CRS has offered a better understanding of the underlying pathophysiology and allows for more targeted treatment. The understanding of systemic disorders and their role in CRS and the importance of topical treatment reaching the sinuses has also allowed for better control of these patients...
September 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28736997/distinct-histopathologic-features-of-radiation-induced-chronic-sinusitis
#10
Hannah N Kuhar, Bobby A Tajudeen, Ashley Heilingoetter, Mahboobeh Mahdavinia, Paolo Gattuso, Ritu Ghai, Ferry Gunawan, Aidnag Z Diaz, George Tolekidis, Pete S Batra
BACKGROUND: Chronic rhinosinusitis (CRS) is a commonly observed sequela after radiation therapy to the paranasal sinuses. The histopathologic features of radiation-induced CRS have yet to be determined and may have major implications in disease management. METHODS: A structured histopathology report was utilized to analyze sinus tissue removed during functional endoscopic sinus surgery (FESS). Histopathology variables, Lund-Mackay score (LMS), and 22-item Sino-Nasal Outcome Test (SNOT-22) scores were compared among patients with radiation-induced CRS (CRSr), CRS without nasal polyps (CRSsNP), and CRS with nasal polyps (CRSwNP)...
October 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28716179/surgical-treatment-of-chronic-rhinosinusitis-after-sinus-lift
#11
Nicole Tin-Lok Jiam, Andrew N Goldberg, Andrew H Murr, Steven D Pletcher
BACKGROUND: The sinus lift (or sinus augmentation) is a common procedure to improve maxillary bone stock before dental implantation. Chronic rhinosinusitis (CRS) is a potential complication of this procedure and may be refractory to medical treatment. Functional endoscopic sinus surgery has previously been used to address CRS, however, results of previous studies indicated that implant removal is required. There are limited follow-up data available. OBJECTIVE: The purpose of this study was to characterize the long-term outcomes and efficacy of endoscopic sinus surgery for refractory CRS after sinus lift, including the ability to salvage dental implants...
July 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28558147/safety-and-efficacy-of-a-bioabsorbable-fluticasone-propionate-eluting-sinus-dressing-in-postoperative-management-of-endoscopic-sinus-surgery-a-randomized-clinical-trial
#12
Gwijde F J P M Adriaensen, Keng-Hua Lim, Wytske J Fokkens
BACKGROUND: Postoperative wound healing after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS) is an important factor in procedural success. Local steroids and separation of opposing mucosa are commonly implemented to optimize healing. A bioabsorbable, fluticasone propionate (FP)-eluting implant, SinuBand FP, was assessed for its safety and efficacy when used in patients with CRS and nasal polyps, who were indicated for ESS including bilateral anterior and posterior ethmoidectomy...
May 30, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28483662/the-management-of-polyps-in-female-reproductive-organs
#13
REVIEW
Vasilios Tanos, Kelsey Elizabeth Berry, Jaana Seikkula, Elissa Abi Raad, Andreas Stavroulis, Zaki Sleiman, Rudi Campo, Stephan Gordts
Polyps of the lower reproductive tract are found in 7.8-50% of women. It has been hypothesized that cytogenetic modifications on chromosomes 6, 7 and 12 as well as epigenetic factors involving enzyme and metabolic activities may cause polyps to develop. Cervical polyps found in 2-5% of cases are of low clinical significance and can cause, although rarely, post coital bleedings. Cervical polyps grow during pregnancy and mucorrhoea. Trans vaginal ultrasound (TVU) provides an excellent diagnostic technique to diagnose the size and the anatomic location of endometrial polyps (EPs)...
May 5, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28434016/chronic-rhinosinusitis-and-mood-disturbance
#14
S E Erskine, C Hopkins, A Clark, S Anari, A Robertson, S Sunkaraneni, J A Wilson, J Beezhold, C M Philpott
BACKGROUND: This study is part of the Chronic Rhinosinusitis Epidemiology Study (CRES). The overarching aim is to determine factors that influence the onset and severity of chronic rhinosinusitis (CRS). The aim of this analysis is to determine whether those with CRS are more likely to report psychiatric morbidity and in particular mood disturbance compared with healthy controls. METHODS: CRES consists of a study-specific questionnaire regarding demographic and socioeconomic factors and past medical history as well as a nasal symptom score (SNOT-22) and SF-36 (QoL - quality of life tool)...
June 1, 2017: Rhinology
https://www.readbyqxmd.com/read/28374869/non-surgical-management-of-chronic-rhinosinusitis-with-nasal-polyps-based-on-clinical-cytological-grading-a-precision-medicine-based-approach
#15
M Gelardi, L Iannuzzi, M De Giosa, S Taliente, N De Candia, N Quaranta, E De Corso, V Seccia, G Ciprandi
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder that strongly impacts patients' quality of life. CRSwNP is still a challenge for ENT specialists due to its unknown pathogenesis, difficult control and frequent relapse. We tested the hypothesis that a new standardised therapeutic approach based on individual clinical-cytological grading (CCG), may improve control of the disease and prevent the needing for surgery. We analysed 204 patients suffering from bilateral CRSwNP, 145 patients of whom regularly assumed therapy, respecting the planned check-up, and were considered cases; 59 patients were not assuming therapy as indicated and were considered as controls...
February 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28281440/monoclonal-antibody-therapy-in-sinonasal-disease
#16
Sergio E Chiarella, Hendrik Sy, Anju T Peters
Chronic rhinosinusitis (CRS) affects 12.5% of the U.S. POPULATION: CRS can be divided into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps. Some individuals with CRSwNP do not respond to standard-of-care medical and surgical management. For these individuals, targeted biologic agents are emerging as an important therapeutic alternative. In this review, we described the most-relevant studies that addressed the use of anti-immunoglobulin E (omalizumab), anti-interleukin 5 (mepolizumab and reslizumab), and anti-interleukin 4/interleukin 13 (dupilumab) monoclonal antibodies for the treatment of CRSwNP...
March 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28116488/antibiofilm-effects-of-topical-corticosteroids-and-intranasal-saline-in-patients-with-chronic-rhinosinusitis-with-nasal-polyps-depend-on-bacterial-species-and-their-biofilm-forming-capacity
#17
Ivana Cirkovic, Bojan Pavlovic, Dragana D Bozic, Ana Jotic, Ljubica Bakic, Jovica Milovanovic
Microbial biofilms have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyposis (CRSwNP). Intranasal application of corticosteroids and saline is a reliable option for their management. The aim of our study was to evaluate in vitro antibiofilm effects of corticosteroids and isotonic and hypertonic nasal saline in CRSwNP patients. The sinus mucosal specimens were harvested from the ethmoid cavity of 48 patients with CRSwNP and further subjected to hematoxylin-eosin staining and microbiology analysis...
April 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28050473/evaluation-of-sinonasal-diseases-by-computed-tomography
#18
Rashmi Kandukuri, Suresh Phatak
INTRODUCTION: Computed Tomography (CT) plays an important diagnostic role in patients with sinonasal diseases and determines the treatment. The CT images clearly show fine structural architecture of bony anatomy thereby determining various anatomical variation, extent of disease and characterization of various inflammatory, benign and malignant sinonasal diseases. AIM: To evaluate sensitivity and specificity of CT in diagnosis of sinonasal diseases and to characterise the benign and malignant lesions with the help of various CT parameters...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27922925/update-on-nonmalignant-lesions-of-the-inferior-turbinate
#19
Jared M Goldfarb, David Goldfarb, Marc R Rosen
PURPOSE OF REVIEW: The inferior turbinates are routinely examined by otolaryngologists on anterior rhinoscopy and nasal endoscopy. Most lesions of the inferior turbinate are benign but can often be confused with malignancy. This review highlights the broad differential of nonmalignant lesions of the inferior turbinates and their management. RECENT FINDINGS: A variety of infectious, inflammatory, neoplastic, and vascular lesions may affect the inferior turbinates...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27859303/prevalence-of-polyp-recurrence-after-endoscopic-sinus-surgery-for-chronic-rhinosinusitis-with-nasal-polyposis
#20
MULTICENTER STUDY
Adam S DeConde, Jess C Mace, Joshua M Levy, Luke Rudmik, Jeremiah A Alt, Timothy L Smith
OBJECTIVES/HYPOTHESIS: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disease process that is driven, in part, by intrinsic mucosal inflammation. Surgery plus continued medical therapy is commonly elected by medically recalcitrant, symptomatic patients. The objective was to evaluate the prevalence of nasal polyp recurrence up to 18 months after endoscopic sinus surgery (ESS) with congruent continuing medical management. STUDY DESIGN: Prospective, multicenter cohort of adult patients undergoing ESS for medically recalcitrant CRSwNP performed between August 2004 and February 2015...
March 2017: Laryngoscope
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