Prades J-M, Chelikh L, Dumollard J-M, Merzougui N, Timoshenko A, Martin Ch
Service d'ORL et chirurgie cervico-faciale, CHU Bellevue, Bd Pasteur, 42055 Saint-Etienne, Cedex 2, France.
Ann Otolaryngol Chir Cervicofac. 2003 Nov;120(5):279-85.
Prospective study designed to count the number of granulocytic cells and eosinophils in nasal polyp tissue removed during ethmoidectomy and to look for anatomical correlations.
Bilateral ethmoidectomy with a postoperative local steroid treatment was performed in 40 patients with nasal polyposis. Immunolabeling of the operative specimen using common leukocyte antigen (CD 45) and granulocytes associated antigen (CD 15) and quantification of the granulocyte infiltrate by image and manual counting of eosinophils with the mean of micro-reticule, were performed. The results were compared to those of 10 healthy subjects. An endoscopy of the postoperative cavities was performed one year after surgery to assess the local results.
The granulocyte and eosinophil infiltrates were significantly more important in the operated patients compared to the healthy population (p<10(- 4)). A "moderate" granulocytic infiltration (G -) was found in 11 patients out of 40 (27.5%). Among them, 9 patients showed less than 30% eosinophils (mean 16.2% +/- 2%). "Severe" granulocytic infiltrate (G +) was found in 29 patients out of 40 (72.5%). Among them, 25 patients showed more than 30% eosinophils (mean 48.8% +/- 2%). Most of the patients with G + type infiltrate suffered from asthma or Widal disease. One year after surgery, 17 out of 29 G + patients had no nasal polyposis recurrence, 12 out of 29 G + patients had a recurrence. However, 12 out of 15 patients with recurrent polyposis had G + type infiltrate.
Granulocyte and eosinophil infiltration cannot be considered as a prognostic factor for recurrence at the time of surgery. A severe granulocyte and eosinophil infiltration is a typical feature of nasal polyposis, particularly in patients with asthma and/or in the aspirin triad.
