Role of Allergy in Sinonasal Polyposis
Affiliation(s)
Department of ENT & Head & Neck Surgery, Kasturba medical College, Mangalore, India. Department of ENT & Head & Neck Surgery, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Chinoutpally., Gannavaram, India. Department Of Community Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Chinoutpally., Gannavaram, India.
Department of ENT & Head & Neck Surgery, Kasturba medical College, Mangalore, India. Department of ENT & Head & Neck Surgery, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Chinoutpally., Gannavaram, India. Department Of Community Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation, Chinoutpally., Gannavaram, India.
ABSTRACT
Objectives: The exact role of allergy in sinonasal polyposis is not yet clearly elucidated and is undoubtedly a contro-versial subject. The study focussed on the association of allergy in nasal polyposis. We aim to determine whether there was a correlation between Serum IgE, absolute eosinophil count, eosinophilic inflammation, and nasal polyps. Methods: A study group of fifty two consecutive patients of nasal polyposis were evaluated prospectively and compared with 26 controls who underwent septoplasty and mimimal FESS or Endoscopic Sphenopalatine artery ligation. Patients were evaluated for presence of allergy with regard to absolute eosinophil count, total serum IGE and tissue eosinophilia and correlations were established. All patients were categorized based on histological evidence of tissue eosinophilia. Re-sults: The incidence of asthma was 5.8% and positive history of allergy was obtained in 40.4% of patients in study group and 7.7% of patients in control group. The statistically significant association was not seen with absolute eosino-phil count, Serum IgE and tissue eosinophilia. Tissue eosinophilia was observed in more number of patients with nasal polyposis compared to controls. So clinical significance might be established. Conclusions: Allergy is parameter that is frequently associated with this disease, irrespective of the type of polyp and the age at presentation. Unrecognized and untreated allergy adds to the morbidity of the disease and generally results in poor treatment outcome.
Objectives: The exact role of allergy in sinonasal polyposis is not yet clearly elucidated and is undoubtedly a contro-versial subject. The study focussed on the association of allergy in nasal polyposis. We aim to determine whether there was a correlation between Serum IgE, absolute eosinophil count, eosinophilic inflammation, and nasal polyps. Methods: A study group of fifty two consecutive patients of nasal polyposis were evaluated prospectively and compared with 26 controls who underwent septoplasty and mimimal FESS or Endoscopic Sphenopalatine artery ligation. Patients were evaluated for presence of allergy with regard to absolute eosinophil count, total serum IGE and tissue eosinophilia and correlations were established. All patients were categorized based on histological evidence of tissue eosinophilia. Re-sults: The incidence of asthma was 5.8% and positive history of allergy was obtained in 40.4% of patients in study group and 7.7% of patients in control group. The statistically significant association was not seen with absolute eosino-phil count, Serum IgE and tissue eosinophilia. Tissue eosinophilia was observed in more number of patients with nasal polyposis compared to controls. So clinical significance might be established. Conclusions: Allergy is parameter that is frequently associated with this disease, irrespective of the type of polyp and the age at presentation. Unrecognized and untreated allergy adds to the morbidity of the disease and generally results in poor treatment outcome.
Cite this paper
M. Hegde, V. Burra and K. Burra, "Role of Allergy in Sinonasal Polyposis," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 1 No. 1, 2012, pp. 1-6. doi: 10.4236/ijohns.2012.11001.
M. Hegde, V. Burra and K. Burra, "Role of Allergy in Sinonasal Polyposis," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 1 No. 1, 2012, pp. 1-6. doi: 10.4236/ijohns.2012.11001.
References
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[1] L. Garin, M. Armengot, J. R. Alba and C. Carda, “Corre- lations between Clinical and Histological Aspects of Na-sal Polyposis,” Acta Otorhinolaryngol, Vol. 59, No. 7, 2008, pp. 315-320. [2] W. Fokkens, V. J. Lund, C. Bachert, P. Clement, P. Hel- lings, M. Holmstrom, “EAACI Position Paper on Rhi-nosinusitis,” Rhinology, Vol. 87, 2005. [3] S. E. Kountakis, P. Arango, D. Bradley, Z. K. Wade and L. Borish, “Molecular and Cellular Staging for the Se- verity of Chronic Rhinosinusitis,” Laryngoscope, Vol. 114, No. 11, pp. 1895-1905. [4] M. Klink, et al., “Problems in Defining Normal Limits for Serum IgE,” Journal of Allergy and Clinical Immunology, Vol. 85, No. 2, 1990, pp. 440-444. doi:10.1016/0091-6749(90)90153-U [5] C. Hopkins, J. P. Browne, R. Slack, V. Lund and P. Browne, “The Lund-Mackay Staging System for Chronic Rhinosinusitis: How Is It Used & What Does It Predict?” Otolaryngology—Head and Neck Surgery, Vol. 137, No. 4, 2007, pp. 555-561. doi:10.1016/j.otohns.2007.02.004 [6] V. J. Lund and I. S. Mackay, “Staging in Rhinosinusitis,” Rhinology, Vol. 31, 1993, 183-184 [7] S. M. Houser and K. J. Keen, “The Role of Allergy and Smokings in Chronic Rhinosinusitis and Polyposis,” La- ryngoscope, Vol. 118, No. 9, 2008, pp. 1521-1527. [8] J. Caplin, T. T. Haynes and J. Spahn, “Are Nasal Polyps an Allergic Phenomenon?” Annals of Allergy, Asthma & Immunology, Vol. 29, 1971, pp. 631-634. [9] A. B. D. Lee, D. Lowe and A. Swantson, et al., “Clinical Profile and Recurrence of Nasal Polyps,” The Journal of Laryngology and Otology, Vol. 98, 1984, pp. 783-793. doi:10.1017/S0022215100147462 [10] B. P. Farrell, “Endoscopic Sinus Surgery: Sinonasal Poly- posis and Allergy,” ENT Journal, Vol. 72, 1993, p. 544. [11] K. G. Marshall, E. L. Attia and D. Danoff, “Disorders of the Nose and Paranasal Sinuses: Diagnosis and Manage-ment,” PSG Publishers, Masachusetts, 2008, pp. 223-227. [12] S. Nikalagh, M. G. Boroujerdinia, N. Saki, M. R. Soltan Moradi and F. Rahim, “Immunological Factors in Patients with Chronic Polypoid Sinusitis,” Nigerian Medical Jour- nal, Vol. 19, No. 3, 2010, pp. 316-319. [13] StenDreborg, “Allergy Diagnosis,” In: N. Mygind and R. M. Naclerio, Eds., Allergic and Non-Allergic Rhinitis, 1st Edition, W.B. Saunders, Philadelphia, pp. 82-92. [14] R. Jankowski, F. Bouchoua, L. Coffinet and J. M. Vig- naud, “Clinical Factors Influencing the Eosinophil Infil- tration of Nasal Polyps,” Rhinology, Vol. 40, No. 4, 2002, pp. 173-178. [15] H. B. Hellquist, “Nasal Polyps Update,” Histopathology, Vol. 17, No. 5, 1996, pp. 237-242. [16] V. L. Schram and M. Z. Effron, “Nasal Polyps in Children,” Laryngoscope, Vol. 90, 1980, pp. 1488-1495. [17] A. Busuttil, H. Chandrachud, A. I. G. Kerr, et al., “Sim- ple Nasal Polyps and Allergic Manifestations,” Journal of Laryngology and Otology, Vol. 92, No. 6, 1978, pp. 477- 487. doi:10.1017/S0022215100085649 [18] J. Staikūniene, S. Vaitkus, L. M. Japertiene and S. Ry- skiene, “Association of Chronic Rhinosinusitis with Nasal Polyps and Asthma: Clinical and Radiological Features, Allergy and Inflammation Markers,” Medicine (Kaunas), Vol. 44, No. 4, 2008, pp. 257-265. [19] M. N. Editorial, “Nasal Polyposis,” The Journal of Al- lergy and Clinical Immunology, Vol. 86, No. 6, 1990, pp. 827-829.