Prognostic factors for recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

Asaka, Daiya; Kanaya, Hiroaki; Kuboki, Akihito; Haruna, Shinichi

doi:10.1016/j.anl.2016.02.015

Cited by 18 publications

(11 citation statements)

References 20 publications

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“…They may be a reason for this finding, but the detailed mechanisms of the relatively high IgE remain unknown. Our result (total IgE, 424.3 ± 926.2 IU/mL; range, 5‐5635 IU/mL; asthma complicating rate, 66.7%) was comparable with some previous reports that assessed for ECRS …”

Section: Discussionsupporting

confidence: 91%

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Short‐term outcomes of olfaction in patients with eosinophilic chronic rhinosinusitis after endoscopic sinus surgery and an assessment of prognostic factors

Akiyama

Samukawa

Hoshikawa

2019

Int Forum Allergy Rhinol

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Background Olfactory dysfunction is one of the common symptoms of eosinophilic chronic rhinosinusitis (ECRS), for which endoscopic sinus surgery (ESS) is the standard treatment. Although the success rates of ESS for restoring olfaction in CRS have been reported, those for ECRS, as defined by new Japanese diagnostic criteria, remain unclear and the parameters affecting improvement rates have not yet been identified. Methods Eighty‐four patients with ECRS who underwent full‐house ESS were retrospectively investigated. Olfactory function was examined using T&T recognition thresholds before and 3 months after surgery. Results The total positive improvement rate in olfaction was 76.2% (64 of 84) and the mean T&T recognition threshold decreased significantly from 5.2 ± 1.1 to 3.0 ± 1.8 after surgery (p < 0.001). Some factors, including negative intravenous olfaction test, presence of olfactory cleft (OC) lesions, a history of sinus surgery, age ≥ 45 years, and being male, were more frequent in the olfaction refractory group. Furthermore, improvement of the T&T recognition threshold was significantly lower for factors of negative intravenous olfaction testing, the presence of OC lesions, and being male. Age and the proportion of blood eosinophils correlated with improvement. Conclusion Herein we examined prognostic factors for olfactory outcomes in ECRS treated with ESS. The intravenous olfaction test, presence of OC lesions, sex differences, and age (the cut‐off value was 45 years) were identified as independent prognostic factors for olfactory outcomes 3 months after surgery.

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Section: Discussionsupporting

confidence: 91%

“…Our result (total IgE, 424.3 ± 926.2 IU/mL; range, 5-5635 IU/mL; asthma complicating rate, 66.7%) was comparable with some previous reports that assessed for ECRS. 19,20 In the present study, all patients met the 2015 JES-REC diagnostic criteria in Japan. 2 Furthermore, all patients were treated with complete full-house ESS.…”

Section: Discussionmentioning

confidence: 87%

Short‐term outcomes of olfaction in patients with eosinophilic chronic rhinosinusitis after endoscopic sinus surgery and an assessment of prognostic factors

Akiyama

Samukawa

Hoshikawa

2019

Int Forum Allergy Rhinol

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“…Full articles of potentially eligible studies were reviewed in depth and their references mined. Finally, 11 individual studies met our inclusion criteria for both the qualitative synthesis and quantitative meta‐analysis Figure shows the study selection process.…”

Section: Resultsmentioning

confidence: 99%

High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta‐analysis

McHugh

Snidvongs

Xie

et al. 2018

Int Forum Allergy Rhinol

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“…Previous studies have reported that better surgical interventions or the long-term application of postoperative intranasal GCs may prevent or delay recurrence [7, 9, 13, 57]. To date, novel parameters and biomarkers, in addition to tissue and peripheral blood eosinophil counts and percentages, have been proposed as predictive factors for recurrence and are worth further investigating, including CLC [33, 34, 41, 58-61].…”

Section: Discussionmentioning

confidence: 99%

Predictive Significance of Charcot-Leyden Crystal Protein in Nasal Secretions in Recurrent Chronic Rhinosinusitis with Nasal Polyps

Yan

Wang

et al. 2020

Int Arch Allergy Immunol

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Introduction: The recurrence occurs frequently among patients with chronic rhinosinusitis with nasal polyps (CRSwNP), and predictors that could be conveniently detected during practice in outpatient service are needed. Objective: We aimed to illustrate that the concentration of Charcot-Leyden crystal (CLC) in nasal secretions can effectively and noninvasively predict polyp recurrence. Methods: 108 patients with CRSwNP were divided into recurrence (n = 68) and recurrence-free (n = 40) groups. Preoperative CLC concentrations in nasal secretions were collected and detected by ELISA. Polyp tissues were harvested during biopsy or endoscopic sinus surgery and were evaluated for inflammatory cells by histopathological staining. Demographic information and the clinical characteristics of each patient were reviewed for associations with recurrence. Binary logistic regression analysis was performed to determine predictive factors for polyp recurrence. Receiver operating characteristic (ROC) curves and the Youden index were performed to determine their predictive values. Survival analysis was performed to compare recurrence risk of patients with different CLC concentrations. Results: Sixty-eight (62.96%) patients developed recurrence during a 12- to 33-month postoperative follow-up. CLC concentrations in nasal secretions were positively correlated with eosinophil percent in polyp tissue and peripheral blood and were significantly higher in patients of the recurrence group than in the patients of the recurrence-free group (p < 0.001). Binary logistic regression and ROC curve demonstrated that CLC protein in nasal secretions is predictive of polyp recurrence. According to the Youden index, a CLC concentration of 34.24 ng/mL can predict postoperative polyp recurrence with 92.6% sensitivity and 87.5% specificity. Patients with CLC concentrations higher than the cutoff value yielded a higher risk of recurrence (p < 0.001, HR = 11.31, 95% CI: 6.41–19.98). Conclusions: CLC protein in nasal secretions may serve as a promising noninvasive biomarker to predict CRSwNP recurrence.

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Prognostic factors for recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

Cited by 18 publications

References 20 publications

Short‐term outcomes of olfaction in patients with eosinophilic chronic rhinosinusitis after endoscopic sinus surgery and an assessment of prognostic factors

Short‐term outcomes of olfaction in patients with eosinophilic chronic rhinosinusitis after endoscopic sinus surgery and an assessment of prognostic factors

High tissue eosinophilia as a marker to predict recurrence for eosinophilic chronic rhinosinusitis: a systematic review and meta‐analysis

Predictive Significance of Charcot-Leyden Crystal Protein in Nasal Secretions in Recurrent Chronic Rhinosinusitis with Nasal Polyps

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