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Eosinophil infiltration of nasal polyps in patients with nasal polyposis: role in clinical evolution after medical and surgical treatment

Published online by Cambridge University Press:  20 May 2008

P Bonfils ,
C Badoual ,
N A Bonfils ,
D Gallas  and
D Malinvaud
P Bonfils*
Affiliation:
Department of ENT, European Hospital Georges Pompidou, Faculty of Medicine, University René Descartes, Paris, France
C Badoual
Affiliation:
Department of Pathology, European Hospital Georges Pompidou, Faculty of Medicine, University René Descartes, Paris, France
N A Bonfils
Affiliation:
Department of ENT, European Hospital Georges Pompidou, Faculty of Medicine, University René Descartes, Paris, France
D Gallas
Affiliation:
ENT Department, Hospital of Senlis, France
D Malinvaud
Affiliation:
Department of ENT, European Hospital Georges Pompidou, Faculty of Medicine, University René Descartes, Paris, France
*
Address for correspondence: Dr Pierre Bonfils, ORL, HEGP, 20 rue Leblanc, 75015 Paris, France. Fax: 33 1 56 09 34 36 E-mail: [email protected]
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Abstract

Objective:

In patients with severe nasal polyposis resistant to strict medical treatment, surgery is indicated, but no prognostic factors for surgery efficacy have yet been determined. Some authors suggest that eosinophilic infiltration of nasal polyps could indicate a risk of surgical ineffectiveness.

Methods:

Surgical plus medical treatment was evaluated over a mean follow-up period of 64 months. One hundred and forty-four subjects were separated into two groups: those with eosinophilic infiltration of >50 per cent (n = 73); and those with ≤50 per cent infiltration (n = 71).

Results:

Combined surgery and corticosteroid therapy was effective in the treatment of severe nasal polyposis. No significant difference was found between the two groups in terms of control of nasal obstruction and sense of smell loss. However, a significant difference was found in terms of control of posterior rhinorrhoea (p = 0.01).

Conclusion:

Eosinophilic infiltration influences the outcome of nasal polyposis surgery, mainly regarding control of posterior rhinorrhoea. It could be considered as a risk factor for surgery in patients with nasal polyposis.

Keywords

Nasal PolypsEosinophilsEndoscopyOtorhinolaryngologic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 5 , May 2009 , pp. 509 - 516
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Bachert, C, Watelet, JB, Bevaert, P, Van Cauwenberge, P. Pharmacological management of nasal polyposis. Drugs 2005;65:1537–52CrossRefGoogle ScholarPubMed
2 Pawankar, R. Nasal polyposis: an update. Curr Opin Allergy Clin Immunol 2003;3:1–6Google Scholar
3 Falliers, CJ. First complete description of the aspirin idiosyncrasy-asthma-nasal polyposis syndrome. J Asthma 1987;24:297–300Google Scholar
4 Eliashar, R, Levi-Schaffer, F. The role of the eosinophil in nasal diseases. Curr Opin Otolaryngol Head Neck Surg 2005;13:171–5CrossRefGoogle ScholarPubMed
5 Bonfils, P. Evaluation of combined medical and surgical treatment in nasal polyposis. I. Functional results. Acta Otolaryngol 2007;127:436–46CrossRefGoogle ScholarPubMed
6 Bonfils, P, Norès, JM, Halimi, P, Avan, P. Corticosteroid treatment in nasal polyposis with a three-year follow-up period. Laryngoscope 2003;113:683–7CrossRefGoogle ScholarPubMed
7 Bonfils, P, Avan, P. Evaluation of the combined medical and surgical treatment in nasal polyposis. II. Influence of a non-specific bronchial hyperresponsiveness. Acta Otolaryngol 2007;127:847–54CrossRefGoogle ScholarPubMed
8 Hissaria, P, Smith, W, Wormald, PJ, Taylor, J, Vadas, M, Gillis, D et al. Short course of systemic corticosteroids in sinonasal polyposis: a double-blind, randomized, placebo-controlled trial with evaluation of outcome measures. J Allergy Clin Immunol 2006;118:128–33CrossRefGoogle ScholarPubMed
9 Patiar, S, Reece, P. Oral steroids for nasal polyps. Cochrane Database Syst Rev 2007 Jan 24; CD005232CrossRefGoogle ScholarPubMed
10 Burgel, PR, Cardell, LO, Ueki, IF, Nadel, JA. Intranasal steroids decrease eosinophils but not mucin expression in nasal polyps. Eur Respir J 2004;24:594–600CrossRefGoogle Scholar
11 Hamilos, DL, Thawley, SE, Kramper, MA, Kamil, A, Hamid, QA. Effect of intranasal fluticasone on cellular infiltration, endothelial adhesion molecule expression, and proinflammatory cytokine mRNA in nasal polyp disease. J Allergy Clin Immunol 1999;103:79–87CrossRefGoogle ScholarPubMed
12 Bonfils, P, Avan, P. Non-specific bronchial hyperresponsiveness is a risk factor for steroid insensitivity in nasal polyposis. Acta Otolaryngol 2004;124:290–6CrossRefGoogle ScholarPubMed
13 Bonfils, P, Avan, P, Halimi, P, Malinvaud, D. Evaluation of the mucosal surface reduction after ethmoidal surgery in nasal polyposis. J Laryngol Otol 2007;121:e8CrossRefGoogle ScholarPubMed
14 Cohn, L, Homer, RJ, MacLeod, H, Mohrs, M, Brombacher, F, Bottomly, K. Th2-induced airway mucus production is dependant on IL-4Ra, but not on eosinophils. J Immunol 1999;162:6178–83CrossRefGoogle Scholar