Chronic Rhinosinusitis with Nasal Polyps in Older Adults: Clinical Presentation, Pathophysiology, and Comorbidity

Song, Woo Jung; Lee, Ji‐Hyang; Won, Ha-Kyeong; Bachert, Claus

doi:10.1007/s11882-019-0880-4

Cited by 25 publications

(27 citation statements)

References 63 publications

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“…More women than men were found in the group of patients with nasal polyposis, most of them younger than 50 years. With regard to the common known mean age of 45-50 years in nasal polyposis [28,29], the mean age of our patients was within this range (47.5 years for males and 47.38 years for females). Interestingly, this is close to the typical age of menopause.…”

Section: Discussionmentioning

confidence: 52%

Level of sex hormones and their association with acetylsalicylic acid intolerance and nasal polyposis

et al. 2020

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Background Chronic rhinosinusitis may be associated with nasal polyposis. Recurrence of disease is often observed and may be due to an intolerance of acetylsalicylic acid. Sex hormones are known to modulate allergic reactions and inflammation. Whether they may be involved in the development and progression of nasal polyposis has not been investigated yet. Aim Examine the relationship between levels of sex hormones and nasal polyposis. Methods Hormonal levels (estradiol, testosterone and progesterone) in patients with nasal polyposis (n = 26) with or without acetylsalicylic acid-intolerance were determined and compared to hormonal levels in patients with septal deviation (n = 35). Cone-beam computed tomography scans were analysed by using scores as defined by Lund and Mackay and by Kennedy. Results Our results show a 5 times greater odds (p = 0.01) for developing nasal polyposis in the presence of lowered estradiol plasma levels than in the presence of normal / elevated levels. When analyzing females and males separately, a 6 times greater odds for females to develop nasal polyposis in the presence of lowered estradiol plasma levels was calculated (p = 0.02). Thus, females are more likely to develop nasal polyposis when they have lowered estradiol levels than males. In addition, female patients showed an increased risk for developing ASA intolerance (p = 0.01). Conclusion Variation of sex hormones may be involved in nasal polyposis. Further studies including more patients to validate the presented results are required. Significance Retrospective clinical investigation suggesting a correlation between varying sex hormones and nasal polyposis.

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Section: Discussionmentioning

confidence: 52%

Level of sex hormones and their association with acetylsalicylic acid intolerance and nasal polyposis

et al. 2020

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“…CRSwNP is viewed as a diffuse inflammatory process, while CRSsNP is linked, at least in part, to sinus outflow obstruction with secondary inflammation and infection, suggesting presence of a mechanical process 4 . Subclassification by the presence or absence of common comorbidities such as asthma 5 or allergies 6,7 has been used. Other phenotypic subclassification has embraced recognized presentations such as Aspirin Triad (AERD, NERD), Allergic Fungal Rhinosinusitis (AFRS), Eosinophilic Granulomatosis with Polyangiitis (EGPA) 8 , Granulomatosis with Polyangiitis (GPA), sinonasal sarcoidosis and CRS with immunodeficiency 9 , although these phenotypes are relatively rare and variably defined.…”

Section: Definition Of Phenotype and Endotypementioning

confidence: 99%

Endotypes of Chronic Rhinosinusitis; relationships to disease phenotypes, pathogenesis, clinical findings and treatment approaches.

Kato¹,

Peters²,

Stevens³

et al. 2021

Preprint

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Chronic rhinosinusitis (CRS) is a common clinical syndrome that produces significant morbidity and costs to our health system. The study of CRS has progressed from an era focused on phenotype to include endotype based information. Phenotypic classification has identified clinical heterogeneity in CRS based on endoscopically observed features such as presence of nasal polyps, presence of comorbid or systemic diseases and timing of disease onset. More recently, laboratory-based findings have established CRS endotype based upon specific mechanisms or molecular biomarkers. Understanding the basis of widespread heterogeneity in the manifestations of CRS is advanced by findings that the three main endotypes, Type 1, 2 and 3, orchestrate the expression of three distinct large sets of genes. The development and use of improved methods of endotyping disease in the clinic is ushering in an expansion of the use of biological therapies targeting Type 2 inflammation now and perhaps other inflammatory endotypes in the near future. The purpose of this review is to discuss the phenotypic and endotypic heterogeneity of CRS from the perspective of advancing the understanding of the pathogenesis and improvement of treatment approaches and outcomes.

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“…Treatment of CPR should begin with the eradication of the pathogen, considering the resistance of the micro-organism and the pharmacological effect of antibiotics (Feshchenko et al 2016;Grayson et al 2019;Iqbal et al 2020). Currently (according to the Eurasian Clinical Recommendations 2016, which are still currently), antibiotics used for the treatment of infectious diseases of the upper respiratory tract are usually divided into 3 lines of therapy (Song et al 2019):…”

Section: Treatmentmentioning

confidence: 99%

Modern approaches to the treatment of chronic polypous rhinosinusitis

Bairashevskaia¹,

Kytko²,

Vasil’ev³

et al. 2020

RRP

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Introduction: Today, chronic polypous rhinosinusitis (CPR) occupies a special place among otolaryngological diseases, the incidence rate of which increases every year. To date, the main causes of chronic polypous rhinosinusitis are Staphylococcus aureus and anatomical abnormalities. Diagnostics: Knowledge of a universal algorithm for the diagnosis of this disease, consisting of the collection of anamnesis, endoscopic examination of the nasal cavity, computed tomography of the paranasal sinuses, anterior active rhinomanometry and bacteriological determination of the microbial spectrum, allows diagnosing chronic polyposis rhinosinusitis in time, and, as a consequence, to prescribe a treatment. Treatment: This review describes conservative therapies, including antibiotics and glucocorticosteroids. Today, the main task of doctors is to find the most effective method of administration of glucocorticosteroids to achieve the maximum effect. One of these methods is the introduction of the drug with the help of nebulizer, as in this case, the drug will remain in the perirhinal cavity for a long time and have the maximum effect due to the directed action only in the area of the pathological process. Features of chronic polypous rhinosinusitis in childhood: It should be noted that children under 12 years of age due to the formation of the paranasal sinuses at different stages of ontogenesis will be characterized by different forms of chronic polyposis rhinosinusitis. That is why they should be known and taken into account when making a diagnosis and prescribing a treatment. Conclusion: Today, the frequency of chronic rhinosinusitis increases exponentially, which makes the question of the modern approach to its treatment the most relevant. It is possible that additional research in this area will solve the issue of searching for both the optimal path of therapy and treatment of CPR in children.

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Chronic Rhinosinusitis with Nasal Polyps in Older Adults: Clinical Presentation, Pathophysiology, and Comorbidity

Cited by 25 publications

References 63 publications

Level of sex hormones and their association with acetylsalicylic acid intolerance and nasal polyposis

Level of sex hormones and their association with acetylsalicylic acid intolerance and nasal polyposis

Endotypes of Chronic Rhinosinusitis; relationships to disease phenotypes, pathogenesis, clinical findings and treatment approaches.

Modern approaches to the treatment of chronic polypous rhinosinusitis

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