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Nasal polyps management

Aakanksha Rathor, Abhinandan Bhattacharjee
Objective: This study aimed to determine whether there is a clinical-radiological correlation in chronic rhinosinusitis (CRS), to compare operative findings with those of computed tomography (CT) imaging, and to determine the importance of a CT score and staging in management of CRS. Methods: This study is a prospective study. Adult patients meeting diagnostic criteria for CRS were prospectively studied using the Lund-Mackay (LM) symptom score and sinus CT scan...
September 2017: World journal of otorhinolaryngology—head and neck surgery
Karin Lisspers, Christer Janson, Kjell Larsson, Gunnar Johansson, Gunilla Telg, Marcus Thuresson, Björn Ställberg
BACKGROUND: Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden. OBJECTIVE: To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population. METHODS: Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers...
March 2018: Respiratory Medicine
F Sireci, R Speciale, S Gallina, R Sorrentino, F R Canevari
The aim of this study is to evaluate the efficacy and safety of prolonged therapy with low-dose clarithromycin in patients with chronic rhinosinusitis with polyps (CRSwP) after endoscopic sinus surgery (ESS). A total of 10 patients with CRSwP were identified and subjected to bilateral ESS. In post-operative patients they were treated with nasal wash with saline solution and steroid sprays (beclomethasone). During follow-up, after 30-40 days after the operation (M = 35.4 SD = +4.33), patients reported a worsening of symptoms with onset of nasal obstruction; reduction/loss of smell; headache; onset of viscous secretions and therefore all patients continued therapy with saline nasal irrigation, topical steroid therapy and started macrolide (clarithromycin 500 mg/pill: 1 pill/day for 3 days a week for 1 month)...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Jay F Piccirillo, Spencer C Payne, Richard M Rosenfeld, Fuad M Baroody, Pete S Batra, John M DelGaudio, David R Edelstein, Andrew P Lane, Amber U Luong, R Peter Manes, Edward D McCoul, Michael P Platt, Douglas D Reh, Maureen D Corrigan
Objective To develop a clinical consensus statement on the use of sinus ostial dilation (SOD) of the paranasal sinuses. Methods An expert panel of otolaryngologists was assembled to represent general otolaryngology and relevant subspecialty societies. The target population is adults 18 years or older with chronic or recurrent rhinosinusitis (with or without nasal polyps, with or without prior sinus surgery) for whom SOD is being recommended, defined as endoscopic use of a balloon device to enlarge or open the outflow tracts of the maxillary, frontal, or sphenoid sinuses, as a standalone procedure or with endoscopic surgery...
February 2018: Otolaryngology—Head and Neck Surgery
Robert C Kern, J Pablo Stolovitzky, Stacey L Silvers, Ameet Singh, Jivianne T Lee, David M Yen, Alfred M C Iloreta, Francis P J Langford, Boris Karanfilov, Keith E Matheny, James W Stambaugh, Anna K Gawlicka
BACKGROUND: Topical intranasal corticosteroid sprays (INCSs) are standard treatment for nasal polyps (NPs), but their efficacy is reduced by poor patient compliance and impaired access of drug to the sinus mucosa. A corticosteroid-eluting sinus implant was designed to address these limitations in patients with recurrent polyposis after sinus surgery by delivering 1350 μg of mometasone furoate (MF) directly to the ethmoid sinus mucosa over approximately 90 days. METHODS: A randomized, sham-controlled, double-blind trial was undertaken in 300 adults with refractory chronic rhinosinusitis with NPs (CRSwNP), who were candidates for repeat surgery...
January 19, 2018: International Forum of Allergy & Rhinology
Kris Ann P Schultz, Gretchen M Williams, Junne Kamihara, Douglas R Stewart, Anne K Harris, Andrew J Bauer, Joyce Turner, Rachana Shah, Katherine Schneider, Kami Wolfe Schneider, Ann Garrity Carr, Laura A Harney, Shari Baldinger, A Lindsay Frazier, Daniel Orbach, Dominik T Schneider, David Malkin, Louis P Dehner, Yoav H Messinger, Ashley Hill
Pathogenic germline DICER1 variants cause a hereditary cancer predisposition syndrome with a variety of manifestations. In addition to conferring increased cancer risks for pleuropulmonary blastoma (PPB) and ovarian sex cord-stromal tumors, particularly Sertoli-Leydig cell tumor, individuals with pathogenic germline DICER1 variants may also develop lung cysts, cystic nephroma, renal sarcoma and Wilms tumor, nodular hyperplasia of the thyroid, nasal chondromesenchymal hamartoma, ciliary body medulloepithelioma, genitourinary embryonal rhabdomyosarcoma and brain tumors including pineoblastoma and pituitary blastoma...
January 17, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Elisabeth H Ference, Jeffrey D Suh, Bruce K Tan, Stephanie Shintani Smith
BACKGROUND: There currently are no data on the relative frequency of endoscopic sinus surgeries (ESS) performed for chronic rhinosinusitis with nasal polyposis (CRSwNP) versus chronic rhinosinusitis without nasal polyposis (CRSsNP) in the United States. OBJECTIVES: To compare the rate of surgical interventions for CRSwNP and CRSsNP. METHODS: Cases identified by CPT codes were extracted from the 2009-2011 State Ambulatory Surgery Databases for California, Florida, Maryland, and New York...
January 1, 2018: American Journal of Rhinology & Allergy
Christopher Jones, Caroline P E Price, Ava R Weibman, Kevin C Welch, David B Conley, Stephanie Shintani-Smith, Whitney W Stevens, Anju T Peters, Leslie Grammer, Alcina K Lidder, Robert P Schleimer, Robert C Kern, Bruce K Tan
BACKGROUND: Chronic rhinosinusitis (CRS) is strongly associated with comorbid asthma. This study compares early-onset and late-onset asthma in a CRS population using patient-reported and clinical characteristics. METHODS: At enrollment into a clinical registry, CRS patients completed the 22-item Sino-Nasal Outcome Test (SNOT-22), Asthma Control Test (ACT), mini-Asthma Quality of Life Questionnaire (miniAQLQ), the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29), and medication use questionnaires...
January 5, 2018: International Forum of Allergy & Rhinology
Gino Marioni, Claudia Zanotti, Giuseppe Brescia
BACKGROUND: The recently reported prevalence of chronic rhinosinusitis (CRS) among people >60 years old was 4.7%, with CRS emerging as the sixth most common chronic condition in the elderly. There is still a dearth of studies that focused on older patients, however, regarding the characteristics of CRS with nasal polyps (CRSwNP). OBJECTIVE: The emerging role of CRSwNP endotyping to enable a tailored medical approach (for elderly patients also) was investigated...
January 1, 2018: Allergy and Asthma Proceedings:
R Jankowski, D T Nguyen, A Russel, B Toussaint, P Gallet, C Rumeau
Chronic nasal dysfunction is a clinical concept in the diagnostic and therapeutic management of sinonasal diseases, based on the evo-devo theory of formation of the nose according to which the nose is not a single organ but rather an association of three organs: olfactory nose, respiratory nose and paranasal sinuses. In chronic nasal dysfunction theory, etiological diagnosis takes account of the possible pathophysiological independence of nasal symptoms, in accordance with the different origins and physiology of the three organs constituting the nose...
February 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Gargi Rai, Mohammad Ahmad Ansari, Sajad Ahmad Dar, Shyama Datt, Neelima Gupta, Sonal Sharma, Shafiul Haque, Vishnampettai Ganapathysubramanian Ramachandran, Arpeeta Mazumdar, Shivprakash Rudramurthy, Arunaloke Chakrabarti, Shukla Das
BACKGROUND: Fungi, especially Aspergillus flavus, can cause chronic rhinosinusitis with nasal polyposis and modulate host innate immune components. The objective of this study was to examine the serum levels of T helper (Th) cell subset Th1, Th2, and Th17 cytokines and total IgE in patients having chronic rhinosinusitis with nasal polyposis and Aspergillus flavus infection. METHODS: A case-control study including 40 patients with chronic rhinosinusitis with nasal polyposis and 20 healthy controls was conducted...
March 2018: Annals of Laboratory Medicine
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
S Maio, S Baldacci, M Bresciani, M Simoni, M Latorre, N Murgia, F Spinozzi, M Braschi, L Antonicelli, B Brunetto, P Iacovacci, P Roazzi, C Pini, M Pata, L La Grasta, P Paggiaro, G Viegi
BACKGROUND: The Italian severe/uncontrolled asthma (SUA) web-based registry encompasses demographic, clinical, functional, and inflammatory data; it aims to raise SUA awareness, identifying specific phenotypes and promoting optimal care. METHODS: Four hundred and ninety three adult patients from 27 Italian centers (recruited in 2011-2014) were analyzed. RESULTS: Mean age was 53.8 years. SUA patients were more frequently female (60.6%), with allergic asthma (83...
October 26, 2017: Allergy
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
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...
February 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
C Philpott, S Erskine, R Smith, C Hopkins, N Kara, A Farboud, M Salam, A Robertson, R Almeyda, B N Kumar, S Anari, J Ray, R Cathcart, S Carrie, S Ahmed, H Khalil, A Clark, M 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
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
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)...
November 2017: International Forum of Allergy & Rhinology
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...
January 2018: Laryngoscope
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
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