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Nasal polyps management

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https://www.readbyqxmd.com/read/28873286/the-impact-of-asthma-on-the-cost-effectiveness-of-surgery-for-chronic-rhinosinusitis-with-nasal-polyps
#1
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
#2
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
#3
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
#4
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)...
July 24, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28716179/surgical-treatment-of-chronic-rhinosinusitis-after-sinus-lift
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/27849652/polyps-asthma-and-allergy-what-s-new
#15
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...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27846022/postoperative-care-in-endoscopic-sinus-surgery-a-critical-review
#16
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...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27817219/current-complications-and-treatment-of-aspirin-exacerbated-respiratory-disease
#17
REVIEW
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...
December 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
#18
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...
May 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27781069/expression-of-vascular-endothelial-growth-factor-in-nasal-polyp-and-chronic-rhinosinusitis
#19
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
#20
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
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