Abstract
OBJECTIVE: To analyze histopathologic mucosal findings as predictors of response to endoscopic sinus surgery (ESS) in allergic and nonallergic patients with chronic rhinosinusitis (CRS). METHODS: Fifty allergic and 50 nonallergic patients with CRS who underwent ESS were enrolled in the study. Patients completed a questionnaire concerning sinusitis symptoms (congestion, discharge, nasal secretion, headache, sneezing, cough, facial swelling and olfaction) before intervention and at 12 and 24 months after surgery. The following histopathologic parameters were assessed: goblet cells, subepithelial thickening, mast cells and eosinophils. Multiple regression analysis was performed to evaluate prediction of total score of subjective symptoms by histopathologic findings. The correlation between histopathologic findings and postoperative symptoms was then evaluated. The results in the two groups were compared. RESULTS: Analysis showed prediction of improvement in total scores at 12 and 24 months after surgery by subepithelial thickening and mast cells in allergic patients (P 0.001). Analysis showed prediction of outcome in nonallergic patients (P 0.05) was not possible. The following histopathologic findings correlate with symptoms at both observed terms in allergic patients: goblet cells correlate with 3 symptoms as well as subepithelial thickening (P 0.005). Mast cells infiltration correlate with 1 symptom (P 0.005). Eosinophilic infiltration does not correlate with any symptom (P 0.05). In the nonallergic patients goblet cells correlate with 4 symptoms (P 0.005). Subepithelial thickening correlates with 3 symptoms (P 0.005). Mast cells infiltration correlates with 2 symptoms as well as eosinophilic infiltration (P 0.005). CONCLUSIONS: Certain histopathologic findings in CRS are predictive of favorable response to ESS.
Published Version
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