Endosinusal treatment impact and prognostic value of IL-5 in chronic maxillary sinusitis

Abstract

Objectives: The aim of the study was to evaluate subjective outcomes in patients with chronic maxillary sinusitis after steroid/antibiotic endosinusal treatment. Furthermore, the aim was to test the hypothesis that pretreatment levels of interleukin-5 (IL-5) in sinus fluid could predict response to endosinusal steroid/antibiotic treatment. Methods: Thirty patients with chronic maxillary sinusitis were recruited for the study. Patients were treated endosinusally with 2 mg dexamethasone and 40 mg gentamycine per maxillary sinus for 5 days. Patients rated nasal/CRS disease-specific symptoms and completed a self-administered questionnaire concerning sinusitis symptoms at inclusion and after 30 days. Sinus lavage, collected at inclusion, was analyzed for IL-5 concentration. Results: 56.6% of patients had improvement after endonasal treatment with decrease in symptoms (responders), and 43.4% were unchanged or worsened after treatment (nonresponders). Significant improvement was noted for overall sinusitis symptoms score ( P = 0.02) and for obstruction, postnasal drip, headache, sneezing, and cough ( P < 0.05). There is positive correlation between baseline IL-5 level in sinus lavage and improvement rate of overall sinusitis symptoms score ( P < 0.01) and improvement rate of nasal secretion score ( P < 0.01). Conclusions: Steroid-antibiotic endosinusal treatment in patients with chronic maxillary sinusitis was proven effective in reducing subjective sinusitis symptoms. Improvement rate to endosinusal treatment is expected be higher in patients with increased level of IL-5 in maxillary sinus lavage. Increased concentrations of IL-5 in sinus fluid might be used as a predictor of a good response to endosinusal treatment of maxillary chronic sinusitis.