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Chronic rhinosinusitis: is the nose really involved?
1Department of Otology and Laryngology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
American Journal of Rhinology
|July 17, 2001
Summary
Chronic rhinitis often accompanies chronic sinusitis, supporting the concept of rhinosinusitis. Histopathology reveals higher eosinophil counts in sinus mucosa, indicating a site-specific role in this condition.
Area of Science:
- Otolaryngology
- Pathology
- Immunology
Background:
- Chronic rhinosinusitis (CRS) is a complex inflammatory condition of the upper airway.
- The relationship between chronic rhinitis and chronic sinusitis requires further clarification.
- Understanding the distinct inflammatory profiles can refine diagnostic and therapeutic approaches.
Purpose of the Study:
- To investigate the co-occurrence of chronic rhinitis and chronic sinusitis.
- To evaluate the histopathological inflammatory patterns in nasal septal and ethmoid sinus mucosa.
- To support or refute the unified concept of chronic rhinosinusitis.
Main Methods:
- Prospective cohort study of 42 patients undergoing endoscopic sinus surgery for CRS.
- Paired nasal septal and ethmoid sinus mucosa specimens were collected.
- Histopathological scoring of inflammation, including eosinophil and inflammatory cell counts per high-power field (HPF).
Main Results:
- Significant correlation found between inflammation grades in septal and ethmoid mucosa (p = 0.048).
- No significant difference in non-eosinophilic inflammatory cell counts between nasal and sinus mucosa (p = 0.061).
- Significantly higher eosinophil counts observed in ethmoid sinus mucosa compared to septal mucosa (p < 0.001).
Conclusions:
- Histopathological evidence of rhinitis is consistently associated with chronic sinusitis.
- Findings support the integrated concept of chronic rhinosinusitis over isolated sinusitis.
- Elevated eosinophils in sinus mucosa suggest a localized inflammatory role in CRS pathogenesis.