Significance of Blood Eosinophil Count in Patients with Chronic Rhinosinusitis with Nasal Polyposis

Chronic Rhino Sinusitis (CRS) is one of the most prevalent chronic illnesses across the globe, affecting persons of all ages. It is an inflammatory process that involves the paranasal sinuses with symptoms lasting longer than 12 weeks.

To establish the significance of blood eosinophil (count) levels in CRS with nasal polyps and to compare blood eosinophil count with eosinophil count in the histopathology specimens of the polyps.

This was a retrospective study done to review the medical records of 63 patients who underwent endoscopic sinus surgery for CRS with Nasal polyps. The patients were divided into two groups, 1 and 2 based on the number of patients suffering from non eosinophilic rhino sinusitis (Group 1) and those from eosinophlic rhino sinusitis (Group 2). The clinical examination findings, nasal endoscopy observations and MDCT-Paranasal sinuses were notified. Also, the mean Eosinophil Count (EC), Absolute Eosinophil Count (AEC), and Histopathology Eosinophil Count (HPE) was compared between two groups. This was aided by CT Scan Lund Mackay Scores (LMS).

Among the patients from Group 1, the male to female ratio was found to be 1.14:1 with 53.3% males and in Group 2 the same were noted as 1.75:1 and 63.6% respectively and found a male preponderance. With regard to symptomatology, significantly higher number of patients in the Group 2 suffered from nasal block (97% vs. 46.7%; p<0.001), nasal obstruction (90.9% vs. 46.7%; p<0.001), nasal discharge (81.8% vs. 56.7%; p=0.030), hyposmia (97% vs. 30%; p<0.001) and asthma (69.7% vs. 3.3%; p<0.001). However, facial pain (66.7% vs. 81.8%; p=0.168) and para nasal sinus tenderness (53.3% vs. 54.6%; p=0.923) were comparable in Groups 1 and 2. Mean EC, AEC and HPE were significantly high in Group 2 compared to Group 1.

The study demonstrated that there was a significant correlation between tissue and blood eosinophil counts with increased severity of symptoms in patients with Eosinophilic CRS with nasal polyps in the Indian population.