[Different phenotypes in patients with chronic sinusitis with bilateral nasal polyps]

Area of Science:

• Otolaryngology
• Allergy and Immunology
• Pathology

Context:

• Chronic sinusitis with bilateral nasal polyps (CRSwBNP) is a complex condition.
• Distinguishing between eosinophilic and non-eosinophilic subtypes is crucial for understanding disease behavior.
• Comorbidities like asthma and atopy significantly influence patient outcomes.

Purpose:

• To investigate the clinical characteristics differentiating eosinophilic CRSwBNP (ECRSwBNP) from non-eosinophilic CRSwBNP (non-ECRSwBNP).
• To identify clinical factors associated with disease recurrence in CRSwBNP patients.
• To evaluate the diagnostic value of specific clinical and imaging parameters for CRSwBNP subtyping.

Summary:

• A retrospective analysis of 134 CRSwBNP patients revealed significant differences between ECRSwBNP and non-ECRSwBNP groups.
• ECRSwBNP patients exhibited higher rates of asthma, atopy, nasal polyp recurrence, eosinophil counts, and serum IgE levels.
• Olfactory cleft CT scores, peripheral blood eosinophil ratios, and sinus CT ratios were identified as valuable indicators for CRSwBNP subtyping, with olfactory cleft score showing the highest diagnostic value.

Impact:

• This study highlights the frequent association of CRSwBNP with asthma and atopy, emphasizing a tendency for recurrence.
• Identifying ECRSwBNP with asthma as a phenotype prone to recurrence underscores the need for targeted, phenotype-based clinical management.
• The findings support the development of personalized treatment strategies for CRSwBNP based on distinct clinical and pathological features.