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Published on: January 19, 2022
Eosinophilic Mucin Rhinosinusitis in Iranian Patients Undergoing Endoscopic Sinus Surgery
Jahangir Ghorbani1, Ali Hosseini Vajari2, Guitti Pourdowlat3
1Chronic Respiratory Diseases Research Center,National Research Institute of Tubeclosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction:
Eosinophilic mucin rhinosinusitis is a type of chronic rhinosinusitis (CRS). Diagnosis and treatment of this condition play a significant role in reducing the patients' clinical symptoms. This type of rhinosinusitis has a higher relapse rate, compared to the other types. This disease is more resistant to treatment and more dependent on corticosteroid therapy, compared to the other types of rhinosinusitis. Regarding this, the present study was designed to evaluate the frequency of eosinophilic mucin rhinosinusitis in patients undergoing sinus surgery in a tertiary referral center and examine some clinical and laboratory characteristics regarding this type of rhinosinusitis.
Materials And Methods:
This cross-sectional observational study was performed on patients over the age of 16 years, who were diagnosed with CRS in the otolaryngology clinic of a referral tertiary-level hospital, and were candidates for endoscopic sinus surgery. Based on the detection of eosinophilic mucin, the subjects were divided into two groups of eosinophilic mucin and non-eosinophilic mucin rhinosinusitis (controls). The groups were compared in terms of sino-nasal outcome test (SNOT-22) scores, Lund-Mackay staging scores, osteitis status, immunoglobulin E (IgE) level, and eosinophilia.
Results:
In this study, 46 subjects participated, 29 (63%) cases of whom had eosinophilic mucin. The SNOT-22 score and serum IgE level were significantly higher in the eosinophilic mucin group, compared to those in the control group. Osteitis and Lund-Mackay scores were also higher in the eosinophilic mucin group than those in the control group; however, this difference was not statistically significant.
Conclusion:
Patients with eosinophilic mucin rhinosinusitis showed a more severe clinical involvement. Seemingly, the Iranian patients have a lower and higher frequency of eosinophilic mucin rhinosinusitis, compared to the patients from the Western countries and East Asia, respectively.
Insights
Eosinophilic mucin rhinosinusitis, a severe form of chronic rhinosinusitis, was more frequent in Iranian patients. This condition showed higher symptom scores and immunoglobulin E levels, indicating greater clinical involvement.
Area of Science:
- Otolaryngology
- Immunology
Background:
- Eosinophilic mucin rhinosinusitis (EMR) is a severe subtype of chronic rhinosinusitis (CRS).
- EMR exhibits higher relapse rates and resistance to treatment compared to other CRS types.
- Corticosteroid therapy is often crucial for managing EMR.
Purpose of the Study:
- To determine the frequency of EMR in patients undergoing sinus surgery.
- To investigate clinical and laboratory characteristics of EMR.
Main Methods:
- A cross-sectional observational study included 46 adult CRS patients undergoing endoscopic sinus surgery.
- Patients were categorized into EMR and non-EMR groups based on eosinophilic mucin detection.
- Comparisons included Sino-Nasal Outcome Test (SNOT-22) scores, Lund-Mackay staging, osteitis, serum immunoglobulin E (IgE), and eosinophilia.
Main Results:
- Eosinophilic mucin rhinosinusitis was diagnosed in 63% of the study participants.
- Patients with EMR had significantly higher SNOT-22 scores and serum IgE levels.
- While osteitis and Lund-Mackay scores were higher in the EMR group, the differences were not statistically significant.
Conclusions:
- EMR is associated with more severe clinical manifestations in Iranian patients.
- The frequency of EMR in Iran appears lower than in Western countries but higher than in East Asia.
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