The analysis of clinical characteristics of the chronic rhinosinusitis: complicated and uncomplicated form

Abstract

The objective of our study was to analyze the intensity of subjective symptoms and objective findings of endoscopy and CT scanning in chronic rhinosinusitis, in the groups with and without nasal polyps. To evaluate the intensity of subjective symptoms visual analogue scale (VAS) was used, while scores were obtained by adding grades. Endoscopic finding was given in scores recommended by Lanza and Kennedy and CT results were presented by Lund-Mackay scoring system. The study included 90 consecutive adult patients, 47 males (52%) and 43 females (48%), mean age 45 years. The group with chronic rhinosinusitis without nasal polyps (uncomplicated form) consisted of 30 patients, while the group with polyps (complicated form) included 60 patients. Comparing mean intensity values of all subjective symptoms between these two groups we found out that nasal obstruction, nasal secretion and hyposmia were significantly more manifested in the polyp group (P<0.01). Facial congestion was also more manifested in the polyp group (P<0.05). Mean score value of major symptoms was 35.55 in the polyp group, and 23.13 in the group without polyps (P<0.01). Mean value of total symptom scores was 48.68 in the polyp group, and 35.00 in the group without polyps (P<0.01). Endoscopic score was approximately 9.03 in the polyp group, and 2.43 in the group without polyps (P<0.01). CT score was 16.05 on an average in the polyp group, and 4.37 in the group without polyps (P<0.01). Chronic rhinosinusitis complicated by nasal polyposis is characterized by higher degree of nasal obstruction, nasal secretion, hyposmia and facial congestion, which results in higher score of major and total score of symptoms, respectively. This form is also characterized by worse objective findings, which is reflected in higher endoscopic and CT scores.

Polypoid changes of the middle turbinate as an indicator of atopic disease

“…Similar to what has been reported in previous studies on generalized nasal polyps, the majority (68%) of patients were found to have bilateral MT polyps . The average age for a patient to be diagnosed with nasal polyps is 45–50 years old . The average age of diagnosis in this study population was 35 years old.…”

Do patients with chronic rhinosinusitis with nasal polyps suffer with facial pain?

“…Bugten et al (30) detected significantly higher mean scores for facial pain and headache among patients with CRSsNP when compared to patients with CRSwNP in a prospective study. Similarly, Dudvarski et al (31) reported the same findings in another prospective study, although their results did not reach statistical significance.…”

Pengaruh Cuci Hidung dengan NaCl 0,9% Terhadap Ekspresi Gen IL-1Beta dan TNF-Alpha Mukosa Hidung Penderita Rinosinusitis Kronis di RSUP Dr M Djamil Padang

“…Keluhan lain pada rinosinusitis kronis berupa keluhan rasa berat di wajah, gangguan penghidu, sakit kepala dan fatigue. [35][36][37] Gejala klinis pada rinosinusitis kronis terjadi akibat penurunan rasio transport mukus yang signifikan dibandingkan pada orang sehat. Hal tersebut berhubungan dengan kerusakan pada silia epitel mukosa hidung yang menyebabkan terganggunya fungsi mukosiliar klirens.…”

“…Kerusakan pada silia terjadi akibat kontak jangka panjang antara mukosa dengan kolonisasi mikroorganisme patogen pada mukosa dan penggunaan antibiotik jangka panjang. [35][36][37] Health & Medical Journal Terdapat perbaikan dalam keluhan subyektif setelah pemberian terapi pada masingmasing kelompok, namun pada pengamatan terhadap perbaikan gejala subyektif tanpa dan dengan cuci hidung, perbaikan gejala gangguan penciuman dan sakit kepala lebih banyak dijumpai pada kelompok perlakuan dibandingkan kelompok kontrol. Pada kelompok kontrol dijumpai perbaikan yang lebih banyak pada gejala hidung tersumbat, rasa tertelan dahak, hidung berair dan bersinbersin dibandingkan pada kelompok perlakuan.…”

“…Penggunaan cuci hidung menjadi perhatian pada penelitian ini dalam memperbaiki gejala klinis dan kualitas hidup penderita rinosinusitis kronis. 35,37 Gejala klinis merupakan suatu keluhan yang bersifat subyektif sehingga diperlukan pemeriksaan objektif untuk menguatkan pemeriksaan subjektif yang didapat. Gejala hidung tersumbat dapat dilakukan dengan pemeriksaan secara objektif dengan menggunakan rinomanometri akustik.…”