Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan.
Department of Otorhinolaryngology-Head and Neck Surgery, Asia University Hospital, Taichung, Taiwan.
Int Forum Allergy Rhinol. 2022 Nov;12(11):1387-1396. doi: 10.1002/alr.22996. Epub 2022 Apr 11.
The characteristics and surgical outcomes of central compartment atopic disease (CCAD) vary by region and race. Therefore, we aimed to identify the risk factors, symptom severity, and prognosis of CCAD in the Asian population.
This case-control study recruited patients diagnosed with chronic rhinosinusitis with nasal polyps who underwent functional endoscopic sinus surgery (FESS) at a tertiary hospital in Taiwan. Patients were classified into CCAD and lateral-dominant nasal polyp (LDNP) groups based on endoscopic and computed tomography imaging findings. The demographic data, symptom severity scores, and surgical outcomes of the 2 groups were analyzed.
Our study included 442 patients (CCAD group: n = 51; LDNP group: n = 391). We found that CCAD was strongly related to both asthma (9.8% vs 3.5%, p = 0.04) and allergic rhinitis symptoms (43.3% vs 26.6%, p = 0.01). Higher eosinophil counts were detected in blood serum (5.8% vs 2.8%, p < 0.01) and histopathologic profiles (57.0 vs 17.3, p < 0.01) among patients with CCAD. Improvements in 22-item Sino-Nasal Outcome Test (SNOT-22) score and mucociliary clearance time (MCT) after surgical intervention revealed that the CCAD group had a better response to FESS (SNOT-22 score: -31.82 vs -22.66, p < 0.01; MCT: -233.06 vs -191.93 seconds, p = 0.03). The revision FESS rate was not different between the 2 groups.
Polyps originating from the central compartment were found to be related to asthma and allergic rhinitis in Taiwanese patients. A higher eosinophil count was suggested in both serum and local nasal tissue from patients with CCAD. FESS serves as an effective treatment for symptom relief in patients with CCAD.
中央隔间特应性疾病(CCAD)的特征和手术结果因地区和种族而异。因此,我们旨在确定亚洲人群中 CCAD 的风险因素、症状严重程度和预后。
本病例对照研究招募了在台湾一家三级医院接受功能性内镜鼻窦手术(FESS)的慢性鼻-鼻窦炎伴鼻息肉患者。根据内镜和计算机断层扫描成像结果,将患者分为 CCAD 和外侧优势鼻息肉(LDNP)组。分析了两组患者的人口统计学数据、症状严重程度评分和手术结果。
我们的研究纳入了 442 名患者(CCAD 组:n = 51;LDNP 组:n = 391)。我们发现 CCAD 与哮喘(9.8%对 3.5%,p = 0.04)和过敏性鼻炎症状(43.3%对 26.6%,p = 0.01)密切相关。CCAD 患者的血清(5.8%对 2.8%,p < 0.01)和组织病理学特征(57.0%对 17.3%,p < 0.01)中嗜酸性粒细胞计数较高。手术后 22 项鼻-鼻窦炎生活质量量表(SNOT-22)评分和黏液纤毛清除时间(MCT)的改善表明,CCAD 组对 FESS 的反应更好(SNOT-22 评分:-31.82 对-22.66,p < 0.01;MCT:-233.06 对-191.93 秒,p = 0.03)。两组的再次 FESS 率没有差异。
在台湾患者中,起源于中央隔间的息肉与哮喘和过敏性鼻炎有关。CCAD 患者的血清和局部鼻组织中嗜酸性粒细胞计数均较高。FESS 是缓解 CCAD 患者症状的有效治疗方法。