TISSUE EOSINOPHILIA IN CHRONIC RHINOSINUSITIS WITH DIFFUSE BILATERAL NASAL POLYPS

Abstract

Background: Inflammatory disease of the nose and paranasal sinuses with diffuse polypoid changes are common findings. The eosinophilic infiltration of the polypoid tissue and eosinophil driven inflammation are one of the endotypes of chronic rhinosinusitis (CRS).
Objective: The study was aimed to investigate the presence of tissue eosinophilia in patients with diffuse bilateral nasal polyps.
Method: It was a descriptive cross-sectional study on 51 patients who underwent Functional Endoscopic Sinus Surgery (FESS) for CRS. Sino-nasal outcome test (SNOT-22) questionnaire and CT scan scores were recorded. Histopathological examination of the polypoid tissue was done and the number of eosinophils per high power field (HPF) was also recorded.
Result: Fifty-one patients were included in the current study, of whom 26 were females and 25 were males. The majority of patients (n=37, 72.5%) had tissue eosinophilia counts > 10 per HPF. The mean CT score in patients with tissue eosinophilia > 10 per HPF was 18.35 (SD 4.08), which was significantly higher than the mean CT score in patients with tissue eosinophilia ≤ 10 per HPF (mean CT score = 12.24, SD 2.67). Similarly, the mean Sino-Nasal outcome Test-22 (SNOT-22) score in patients with tissue eosinophilia >10 was 71.25 (SD 5.84), which was significantly higher than the mean SNOT-22 score in patients with tissue eosinophilia ≤10 (mean SNOT-22 score = 57.85, SD 4.49).
Conclusion: There was a significant positive correlation between tissue eosinophil count and both SNOT-22 score and CT score.
Keywords: Diffuse nasal polyp, Eosinophilic Chronic Rhinosinusitis, SNOT-22, Tissue eosinophilia.