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Tissue eosinophilia and computed tomography features in paediatric chronic rhinosinusitis with nasal polyps requiring

P-W Wu1, C-H Chiu2, Y-L Huang3

  • 1Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan;School of Medicine, Chang Gung University, Taoyuan, Taiwan.

Rhinology
|April 28, 2023
PubMed

Insights

Children undergoing revision endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis (CRSwNP) show higher tissue eosinophilia. A new nomogram predicts revision surgery needs in pediatric CRSwNP patients.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Immunology

Background:

  • Endoscopic sinus surgery (ESS) is a safe treatment for pediatric chronic rhinosinusitis with nasal polyposis (CRSwNP).
  • Recalcitrant cases may require revision surgery.
  • Understanding inflammatory patterns in revision cases is crucial.

Purpose of the Study:

  • To identify inflammatory patterns and clinical features of CRSwNP in children needing revision ESS.
  • To develop a predictive model for revision surgery in pediatric CRSwNP.

Main Methods:

  • Retrospective analysis of 146 pediatric CRSwNP patients, with 22 undergoing revision surgery.
  • Comparison of clinical data, CT scans, tissue eosinophil counts, and cytokine immunoactivity.
  • Logistic regression analysis to develop a predictive nomogram.

Main Results:

  • Revision surgery patients had higher tissue eosinophil infiltration and IL-5/eosinophilic cationic protein immunoreactivity.
  • Younger age, positive aeroallergen tests, higher Lund-Mackay scores, and ethmoid/maxillary ratio on CT were associated with revision.
  • A nomogram was developed to predict the need for revision surgery.

Conclusions:

  • A nomogram integrating clinical, tissue, and CT findings can preoperatively identify pediatric CRSwNP patients at risk for revision surgery.
  • This tool aids in predicting recurrence and guiding postoperative management.
  • Early identification allows for tailored, intensive follow-up and adjuvant therapies.
Abstract

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