TY - JOUR
T1 - Disease involvement in the central compartment in eosinophilic chronic rhinosinusitis
AU - Makary, Chadi A.
AU - Falco, Jeffrey
AU - Sussman, Sarah
AU - Ryan, Lindsey
AU - Reyes, Camilo
AU - Ramadan, Hassan
AU - Kountakis, Stilianos E.
N1 - Publisher Copyright:
© 2021 ARS-AAOA, LLC
PY - 2021/10
Y1 - 2021/10
N2 - Objective: To evaluate disease presence in the central compartment (CC) in patients with eosinophilic chronic rhinosinusitis (CRS). Methods: Patients with eosinophilic CRS were divided into three endotypes: aspirin-exacerbated respiratory disease (AERD), allergic fungal rhinosinusitis (AFRS), and eosinophilic CRS with nasal polyps (eCRSwNP). CT scans were reviewed for CC involvement, defined as the area between the superior nasal septum (SNS) and middle turbinate (MT). CC involvement was measured based on the degree of opacification (0: no opacification, 1: up to 50% opacification, and 2: >50% opacification), and distance from SNS to MT (mm). Patients who had lateralized MTs from prior surgery as the cause of CC widening were excluded. Patients who underwent orbital decompression were included as a control group. Results: Fifty patients in each group (AERD, AFRS, and eCRSwNP) and 50 control patients were included. Average number of surgeries was 2.5 in AERD (p = 0.05), 2 in AFRS (p = 0.4), and 1.7 in eCRSwNP. Preoperative CC distance was significantly higher in AERD versus control, AFRS, and eCRSwNP: 4.2 versus 2.8 mm (p < 0.0001), 4.2 versus 1.9 mm (p < 0.0001), and 4.2 versus 2.7 mm (p < 0.0001), respectively. Postoperatively, CC distance and degree of opacification were significantly higher in AERD versus control, AFRS, and eCRSwNP. Within the AERD group, CC distance was significantly higher postoperatively than preoperatively (6.5 vs. 4.2 mm, p = 0.002). Conclusion: CC involvement is more significant in AERD patients and if present, rhinologists should be suspicious of the diagnosis. This area could represent a source of inflammatory load in patients with AERD.
AB - Objective: To evaluate disease presence in the central compartment (CC) in patients with eosinophilic chronic rhinosinusitis (CRS). Methods: Patients with eosinophilic CRS were divided into three endotypes: aspirin-exacerbated respiratory disease (AERD), allergic fungal rhinosinusitis (AFRS), and eosinophilic CRS with nasal polyps (eCRSwNP). CT scans were reviewed for CC involvement, defined as the area between the superior nasal septum (SNS) and middle turbinate (MT). CC involvement was measured based on the degree of opacification (0: no opacification, 1: up to 50% opacification, and 2: >50% opacification), and distance from SNS to MT (mm). Patients who had lateralized MTs from prior surgery as the cause of CC widening were excluded. Patients who underwent orbital decompression were included as a control group. Results: Fifty patients in each group (AERD, AFRS, and eCRSwNP) and 50 control patients were included. Average number of surgeries was 2.5 in AERD (p = 0.05), 2 in AFRS (p = 0.4), and 1.7 in eCRSwNP. Preoperative CC distance was significantly higher in AERD versus control, AFRS, and eCRSwNP: 4.2 versus 2.8 mm (p < 0.0001), 4.2 versus 1.9 mm (p < 0.0001), and 4.2 versus 2.7 mm (p < 0.0001), respectively. Postoperatively, CC distance and degree of opacification were significantly higher in AERD versus control, AFRS, and eCRSwNP. Within the AERD group, CC distance was significantly higher postoperatively than preoperatively (6.5 vs. 4.2 mm, p = 0.002). Conclusion: CC involvement is more significant in AERD patients and if present, rhinologists should be suspicious of the diagnosis. This area could represent a source of inflammatory load in patients with AERD.
KW - chronic rhinosinusitis
KW - eosinophilic rhinitis and nasal polyposis
KW - imaging
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U2 - 10.1002/alr.22803
DO - 10.1002/alr.22803
M3 - Article
C2 - 33864707
AN - SCOPUS:85104486842
SN - 2042-6976
VL - 11
SP - 1417
EP - 1423
JO - International Forum of Allergy and Rhinology
JF - International Forum of Allergy and Rhinology
IS - 10
ER -