The Impact of Allergic Rhinitis on Ciliary Function of Nasal Mucosa in Children With Chronic Rhinosinusitis in Postoperative Period

Abstract

The objective of the study is investigation of the impact of allergic rhinitis on ciliary function in children with chronic rhinosinusitis in postoperative period. A total of 131 pediatric patients aged 4-17 years old were involved in the present study. All patients were subjected to functional endoscopic sinonasal surgery. Depending on the presence of allergic rhinitis all examinees were divided into two groups, namely patients with CRS and AR (n = 20) and AR-free CRS patients (n = 111). Assessment of sinonasal pathology was performed using Sino-Nasal-Outcome-Test 20 (SNOT-20) questionnaire, as well as endoscopic and radiological investigation with subsequent evaluation of Lund-Kennedy and Lund-Mackay scores, respectively. Investigation of ciliary function, morphology, and cytology of nasal mucosa was performed using videocytometric analysis. The obtained data demonstrate that sinonasal pathology was significantly (p < 0,001) reduced after surgical treatment of CRS independently of AR status. At the same time, AR possessed a significant impact on reparation of nasal mucosa ciliary function and morphology in the postoperative period. Specifically, at 12 months after the surgery pediatric patients with CRS and AR were characterized by a twofold lower relative number of cells with motile cilia (р = 0,009), twofold lower number of cases of ciliary beat synchronicity (р = 0,035), a 26 % reduction in cell survival (р = 0,025), as well as 90 % higher number of cases with severe epithelial dystrophy (р = 0,030) as compared to AR-free CRS patients. Therefore, the obtained data demonstrate that AR significantly affects postoperative mucosal reparation in CRS patients after functional endoscopic sinonasal surgery.