Clinical Characteristics of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps in Adolescents

Chien-Chia Huang; Po-Hung Chang; Yen-Lin Huang; Ta-Jen Lee; Chi-Che Huang; Pei-Wen Wu

doi:10.2147/JAA.S437876

Clinical Characteristics of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps in Adolescents

J Asthma Allergy. 2023 Oct 30:16:1197-1206. doi: 10.2147/JAA.S437876. eCollection 2023.

Authors

Chien-Chia Huang^{1

2}, Po-Hung Chang^#¹, Yen-Lin Huang^{3

4

5}, Ta-Jen Lee^{1

2

6}, Chi-Che Huang^{1

2}, Pei-Wen Wu^#^{1

2}

Affiliations

¹ Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
² School of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Department of Anatomic Pathology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁴ School of Medicine, National Tsing-Hua University, Hsinchu, Taiwan.
⁵ Institute of Stem Cell and Translational Cancer Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁶ Department of Otolaryngology, Xiamen Chang Gung Hospital, Xiamen, People's Republic of China.

^# Contributed equally.

Abstract

Introduction: Eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is frequently associated with greater inflammation, poorer prognosis, and a high recurrence rate after sinus surgery.

Objective: This study evaluated the clinical and imaging characteristics of eosinophilic CRSwNP in patients aged 12-17.

Methods: We retrospectively enrolled 139 patients aged 12-17 with bilateral CRSwNP. Clinical characteristics, computed tomography (CT) features, tissue eosinophil counts, and eosinophil activity were evaluated.

Results: Twenty-three (16.5%) patients had recurrent nasal polyps that required revision surgery. Patients requiring revision surgery had higher tissue eosinophil infiltration in the sinus mucosa than those not requiring revision surgery. The optimal cut-off value to distinguish the need for revision surgery was a tissue eosinophil count > 21.5/high-power field determined by the receiver operating characteristic curve. The Lund-Mackay and olfactory cleft opacification scores on CT images were significant predictors of tissue eosinophil count in the univariate analysis, and only olfactory opacification scores remained statistically significant in the multivariate analysis.

Conclusion: This study revealed that the CT feature of the olfactory cleft opacification score could be a significant characteristic of eosinophilic CRSwNP in adolescents.

Keywords: adolescent; chronic rhinosinusitis; computed tomography; eosinophil; nasal polyp.

Grants and funding

The authors received research grants from the Chang Gung Memorial Hospital (CMRPG2K0161) and Taiwan National Science and Technology Council (110-2314-B-182 -063 -; 111-2314-B-182 -067 -;111-2635-B-182A-008 -). The funder had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.