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Nasal polyps management

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https://www.readbyqxmd.com/read/27859303/prevalence-of-polyp-recurrence-after-endoscopic-sinus-surgery-for-chronic-rhinosinusitis-with-nasal-polyposis
#1
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...
November 12, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27849652/polyps-asthma-and-allergy-what-s-new
#2
Dimitrios Terzakis, Christos Georgalas
PURPOSE OF REVIEW: Although chronic rhinosinusitis with nasal polyps, asthma, and allergy share common inflammatory mechanisms, there is no evidence of cause-and-effect relationship. In this review, we present new studies investigating the complex immunology that links these diseases. Advances in new therapies as well as evidence regarding indication and timing of surgery, especially of more complex cases, are highlighted. RECENT FINDINGS: New studies have endotyped patients in an effort to describe the exact inflammatory profile of each phenotype, whereas described cytokines seem to play a significant role in amplification of T2 inflammation, directly or via innate lymphoid cells...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27846022/postoperative-care-in-endoscopic-sinus-surgery-a-critical-review
#3
Philippe Eloy, Peter Andrews, Anne-Lise Poirrier
PURPOSE OF REVIEW: Chronic rhinosinusitis with and without nasal polyps is a common disease affecting people all over the world. Functional endoscopic sinus surgery (FESS) has become the gold standard treatment for medically refractive disease. Postoperative care is recommended by international leaders as an important part of the patient's management. This article is a critical review and discussion focusing on postoperative care, which is based on expert opinion, clinical studies, randomized controlled trials and meta-analysis studies...
November 14, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27817219/current-complications-and-treatment-of-aspirin-exacerbated-respiratory-disease
#4
Kevin A Cook, Donald D Stevenson
Aspirin-exacerbated respiratory disease is defined by the clinical tetrad of aspirin sensitivity, nasal polyps, asthma, and chronic rhinosinusitis. Patients experience acute upper and lower airway reactions with exposure to aspirin and other cyclooxygenase-1 inhibiting medications. However, airway inflammation and disease progression occur even in the absence of exposure to these medications, often leading to aggressive polyp formation and need for systemic corticosteroids to treat exacerbations in asthma and rhinosinusitis...
November 17, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27809696/the-impact-of-chronic-rhinosinusitis-on-long-term-survival-in-lung-transplantation-recipients
#5
Shin Kariya, Mitsuhiro Okano, Takahiro Oto, Takaya Higaki, Takenori Haruna, Yohei Noda, Kazunori Nishizaki
CONCLUSIONS: Chronic rhinosinusitis diagnosed according to the European Position Paper on Rhinosinusitis and Nasal Polyps 2012, not by computed tomography alone, is one of the prognostic factors affecting long-term survival in patients with lung transplantation. Endoscopic sinus surgery might play a beneficial role in the management of lung transplantation recipients with chronic rhinosinusitis. OBJECTIVE: To show the effect of paranasal sinus infection on post-lung transplantation survival...
November 4, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27781069/expression-of-vascular-endothelial-growth-factor-in-nasal-polyp-and-chronic-rhinosinusitis
#6
REVIEW
Alireza Azizzadeh Delshad, Mohammadreza Jalali Nadoushan, Ali Davati, Aida Rostami
BACKGROUND: Nasal inflammatory disorders such as chronic rhinosinusitis and nasal polyp are among the most prevalent complications with high socioeconomic costs. Vascular Endothelial Growth Factor (VEGF) plays a key role in angiogenesis and cell proliferation. In the present study the effect of VEGF on the development and prognosis of chronic rhinosinusitis and nasal polyp was investigated. METHODS: This cross sectional study was performed on the nasal histological specimens of two groups of patients suffering from nasal polyp or chronic rhinosinusitis, and the expression of VEGF in the two groups was compared immunohistochemically...
2016: Iranian Journal of Pathology
https://www.readbyqxmd.com/read/27712761/diagnostic-evaluation-in-aspirin-exacerbated-respiratory-disease
#7
Adam N Williams
Aspirin-exacerbated respiratory disease (AERD) is a distinct clinical condition characterized by chronic sinusitis with nasal polyps, asthma, and hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs). Distinguishing AERD from other forms of chronic sinusitis, asthma, and NSAID reactivity has important clinical implications for management. The clinical history is helpful, but not adequate for confirming the diagnosis of AERD, in most cases. Diagnostic provocation challenge remains the only way to confirm or exclude the diagnosis of AERD...
November 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27538737/aspirin-exacerbated-respiratory-disease-and-current-treatment-modalities
#8
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
https://www.readbyqxmd.com/read/27515764/analysis-and-results-of-endoscopic-sinus-surgery-in-chronic-rhinosinusitis-with-polyps
#9
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
https://www.readbyqxmd.com/read/27466858/outcomes-in-medical-and-surgical-treatment-of-nasal-polyps
#10
Aria Jafari, Adam S DeConde
Chronic rhinosinusitis with nasal polyps is a heterogeneous disease with a variety of medical and surgical options available to the patient and provider. Consensus statements and recent trends in outcomes research advocate that treatment be driven by patient-reported outcome measures. To this end, there has been increasing sophistication and nuance in both the outcome instruments themselves, as well as the method in which they are collected and interpreted. This is reflected in concepts such as the minimally clinically important difference and domain stratification, which have helped clinicians understand patient motivations and response to treatment...
2016: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27466855/implantable-devices-drugs-in-the-management-of-nasal-polyps
#11
Griffin D Santarelli, Joseph K Han
The use of biomaterials, which include nasal packing and sinus stents, has an evolving role in the postoperative management of patients with chronic rhinosinusitis with polyps. Some of these biomaterials include drug-eluting properties. The usage of biomaterials postoperatively is both surgeon and patient specific. The published literature supports the use of these products and demonstrates the ability to limit swelling, lateralization and reduce polyp regrowth postoperatively. However, there are heterogeneity in both available materials and results that the otolaryngologist must factor in to the decision-making algorithm...
2016: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27466854/topical-steroids
#12
Gretchen M Oakley, Richard J Harvey
Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory condition with heterogeneous pathophysiology. A cornerstone of the management of this condition is the use of anti-inflammatory agents. Corticosteroids are very effective and the most commonly used, but other drugs with immunodulatory activity such as anti-IL5, doxycycline (Th2), and macrolides (anti-neutrophilic/IL8) have been shown to have efficacy. Although systemic corticosteroids have shown benefit in managing this condition, the frequency of use often required in this condition is associated with significant adverse effects...
2016: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27440486/cost-utility-analysis-of-endoscopic-sinus-surgery-for-chronic-rhinosinusitis-with-and-without-nasal-polyposis
#13
George A Scangas, Aaron K Remenschneider, Brooke M Su, Mark G Shrime, Ralph Metson
OBJECTIVE: To evaluate the cost-effectiveness of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis (CRS) with and without nasal polyposis (NP). STUDY DESIGN: Cohort-style Markov decision-tree economic model with a 36-year time horizon. METHODS: Two cohorts of 229 CRS patients with and without NP who underwent ESS were compared with a matched cohort of 229 CRS patients from the Medical Expenditures Survey Panel database (Agency for Healthcare Research and Quality, Rockville, MD) who underwent medical management...
July 21, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27440128/the-effectiveness-of-budesonide-nasal-irrigation-after-endoscopic-sinus-surgery-in-chronic-rhinosinusitis-with-asthma
#14
Tae Wook Kang, Jae Ho Chung, Seok Hyun Cho, Seung Hwan Lee, Kyung Rae Kim, Jin Hyeok Jeong
Objectives: Budesonide nasal irrigation was introduced recently for postoperative management of patients with chronic rhinosinusitis. The safety and therapeutic effectiveness of this procedure is becoming accepted by many physicians. The objective of this study was to evaluate the efficacy of postoperative steroid irrigation in patients with chronic rhinosinusitis and asthma. Methods: This prospective study involved 12 chronic rhinosinusitis patients with nasal polyps and asthma who received oral steroid treatment for recurring or worsening disease...
July 21, 2016: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/27393775/chronic-rhinosinusitis-in-patients-with-cystic-fibrosis
#15
Daniel L Hamilos
Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and accounts for significant morbidity and contribution to CF lung disease. Mutations of the cystic fibrosis transmembrane regulator gene occur with increased prevalence in patients with CRS without CF, suggesting some contribution to CRS pathophysiology. Nasal polyps (NPs) occur with increased prevalence in patients with CF of all ages and have a more neutrophilic appearance with fewer eosinophils and increased submucosal glandular elements in comparison to NPs from patients without CF...
July 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27393770/chronic-rhinosinusitis-with-nasal-polyps
#16
Whitney W Stevens, Robert P Schleimer, Robert C Kern
Chronic rhinosinusitis with nasal polyps (CRSwNP) is an important clinical entity diagnosed by the presence of both subjective and objective evidence of chronic sinonasal inflammation. Symptoms include anterior or posterior rhinorrhea, nasal congestion, hyposmia, and/or facial pressure or pain that last for a duration of more than 12 weeks. Nasal polyps are inflammatory lesions that project into the nasal airway, are typically bilateral, and originate from the ethmoid sinus. Males are more likely to be affected than females, but no specific genetic or environmental factors have been strongly linked to the development of this disorder to date...
July 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27218483/longitudinal-improvement-and-stability-of-olfactory-function-in-the-evaluation-of-surgical-management-for-chronic-rhinosinusitis
#17
Joshua M Levy, Jess C Mace, E Ritter Sansoni, Zachary M Soler, Timothy L Smith
BACKGROUND: Abnormal olfaction is common with chronic rhinosinusitis (CRS) and associates with various measures of sinonasal inflammation. The Brief Smell Identification Test (BSIT) has demonstrated improvements in abnormal olfactory detection following endoscopic sinus surgery (ESS), but olfaction remains understudied using this instrument. Discerning longitudinal, postoperative durability in olfaction is critical for patient counseling. METHODS: Adult participants with medically recalcitrant CRS were prospectively enrolled into a multi-institutional cohort study and observed for 18 months after ESS...
November 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27171958/chronic-rhinosinusitis-with-massive-polyposis-causing-proptosis-requiring-craniofacial-resection
#18
Mazda K Turel, Christopher J Chin, Allan D Vescan, Fred Gentili
Chronic rhinosinusitis (CRS) is a common health problem in the Western world. CRS is classified as CRS with (CRSwNP) and without (CRSsNP) nasal polyps. A less common third type is allergic fungal sinusitis, which often presents with polyps and, not infrequently, skull base erosion. Most patients are successfully managed with maximal medical therapy or endoscopic approaches. There are currently no reports of CRSwNPs resulting in fibro-osseous thickening and proptosis in the English literature. As such, the authors report a case of a 33-year-old man who underwent a craniofacial resection with drilling of the hyperostosed bone, which led to resolution of the proptosis and nasal symptoms...
June 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27141307/mometasone-furoate-nasal-spray-a-systematic-review
#19
REVIEW
Desiderio Passali, Maria Carla Spinosi, Anna Crisanti, Luisa Maria Bellussi
UNLABELLED: The inflammatory diseases of the nose, rhino-pharynx and paranasal sinuses (allergic and non allergic rhinitis, NARES; rhinosinusitis with/without nasal polyposis, adenoidal hypertrophy with/without middle ear involvement) clinically manifest themselves with symptoms and complications severely affecting quality of life and health care expenditure. Intranasal administration of corticosteroids, being fast, simple, and not requiring cooperation, is the preferred way to treat the patients, to optimize their quality of life, at the same time minimizing the risk of exacerbations and complications...
2016: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/27126722/update-on-the-management-of-aspirin-exacerbated-respiratory-disease
#20
REVIEW
Kathleen M Buchheit, Tanya M Laidlaw
Aspirin-exacerbated respiratory disease (AERD) is an adult-onset upper and lower airway disease consisting of eosinophilic nasal polyps, asthma, and respiratory reactions to cyclooxygenase 1 (COX-1) inhibitors. Management includes guideline-based treatment of asthma and sinus disease, avoidance of COX-1 inhibitors, and for some patients aspirin desensitization followed by high-dose aspirin therapy. Despite this, many patients have inadequately controlled symptoms and require multiple sinus surgeries. In this review, we discuss the current standard approaches to the management of AERD, and we introduce several therapeutics under development that may hold promise for the treatment of AERD...
July 2016: Allergy, Asthma & Immunology Research
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