RESUMEN
It seems apparently that the 2 separate anatomical areas (nasal cavity and paranasal sinus mucosa) are indeed one single unit with an identical behavior during inflammatory process. Similar histopathologic evidence in long-term condition could emphasize on the concept of rhinosinusitis in patients with inflammatory paranasal sinus disease. Prospective study was performed on 50 consecutive patients with polyposis in 2 different groups, one with and the other without asthma. Inferior turbine and polyp with ethmoid sinus origin were selected to compare the histopathologic findings of the surgical specimens from the 2 sites (affected sinus vs apparently unaffected nose). The general degree of inflammation, epithelial thickening, and inflammatory cell count were measured. The degree of inferior turbinate inflammation correlated with that of the ipsilateral polyp of ethmoid sinus in both groups. In addition, the total inflammatory cell count was comparable. There was no statistically significant difference in total polymorphonuclear, lymphocyte, and eosinophil count between the 2 sites in each group (P > .05). The ethmoid sinus inflammation in polypoid chronic sinusitis is accompanied by a proportionate inferior turbinate inflammation, not only in the patients with asthma but also in those with isolated sinonasal polyposis.
Asunto(s)
Senos Etmoidales/patología , Sinusitis del Etmoides/patología , Pólipos Nasales/patología , Rinitis/patología , Cornetes Nasales/patología , Adolescente , Adulto , Anciano , Asma/complicaciones , Asma/patología , Enfermedad Crónica , Sinusitis del Etmoides/complicaciones , Sinusitis del Etmoides/cirugía , Femenino , Humanos , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Pólipos Nasales/complicaciones , Pólipos Nasales/cirugía , Estudios Prospectivos , Rinitis/complicaciones , Rinitis/cirugía , Adulto JovenRESUMEN
INTRODUCTION: Considering the different clinical aspects of polyps in asthmatic and nonasthmatic patients, we aimed to explore their histopathological characteristics. MATERIAL AND METHODS: Twenty-five asthmatic patients and 25 nonasthmatic patients with polypoid chronic rhinosinusitis (29 male, 21 female; mean age 41.3 +/- 13.27; range 15-78 years) were enrolled in the study to be compared on the basis of histopathological characteristics. They were compared according to the following seven light microscopic findings: basement membrane thickness, goblet cell hyperplasia, subepithelial edema, submucous gland formation, eosinophilic infiltration, lymphocytic infiltration, and polymorphonuclear infiltration. RESULTS: Basement membrane thickening, goblet cell hyperplasia, and eosinophilic and lymphocytic infiltration were more prominent in the asthmatic compared with the nonasthmatic group (P < 0.05), whereas polymorphonuclear infiltration was more prominent in nonasthmatics (P < 0.05). No statistically significant differences were found between the two groups with regard to submucosal gland hyperplasia or subepithelial edema. CONCLUSION: Asthmatic patients present histopathological characteristics of a marked chronic inflammatory reaction, which might explain the negative effect on chronic rhinosinusitis outcome and the severity of the disease in this group.