Clinical characteristics in Japanese patients with chronic rhinosinusitis who underwent endoscopic sinus surgery.

Oct 16, 2023

Experts: Natsuki Inoue,Tomomitsu Hirota,Akihiro Hatano,Mika Nakano,Daiki Nakashima,Tsuguhisa Nakayama,Mayumi Tamari,Mamoru Yoshikawa

There is heterogeneity in the pathophysiology of chronic rhinosinusitis (CRS). Obtaining a detailed understanding of patient profiles in specific regions can provide valuable information not only for clinical practice but also future research plans. The aim of this study was to investigate the characteristics of patients who underwent endoscopic sinus surgery (ESS) for CRS.
This retrospective, single-center study examined the features of 453 patients with CRS who underwent ESS in the Tokyo area of Japan. The study evaluated various factors in patients with CRS including sex and age, the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) score, the recurrence rate of CRS, comorbidities of asthma and/or allergic diseases, and IgE sensitization to 12 inhaled allergens.
Age-related declines in the sensitization rate to inhaled allergens were observed, and the most notable age-related decrease in specific IgE antibodies was observed for house dust mites (HDM) (p = 8.3 × 10). Sensitization to HDM, cat dander, and various types of fungi, including Aspergillus, was frequently observed in the CRS with asthma group, with rates of 54%, 17%, and 17%, respectively. We found that 23% of the patients had recurrence. In the recurrence group, the positive rates of specific IgE antibodies for birch and cat dander were significantly higher than in the no recurrence group. Bronchial asthma was identified as an important factor for recurrence. Among male patients, the recurrence group was younger than the no-recurrence group (p = 0.0032). Severe eosinophilic CRS (ECRS) showed early recurrence after surgery, with over the half of the patients experiencing at least one recurrence within 2 years post-surgery. Among patients with ECRS, the recurrence rate for females was 1.92 times higher than for males.
Our study revealed the influences of age and sex on various clinical phenotypes of CRS patients undergoing ESS. There was a high sensitization rate to cat dander in both the recurrence and asthma groups. Further research on diverse disease etiologies is necessary to improve therapeutic strategies for patients with CRS.

Copyright © 2023. Published by Elsevier B.V.

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ABOUT THE EXPERTS

Natsuki Inoue,Tomomitsu Hirota,Akihiro Hatano,Mika Nakano,Daiki Nakashima,Tsuguhisa Nakayama,Mayumi Tamari,Mamoru Yoshikawa

Natsuki Inoue

Department of Otorhinolaryngology, Toho University Graduate School of Medicine, Tokyo, Japan; Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan; Division of Molecular Genetics, Research Center for Medical Science, The Jikei University School of Medicine, Tokyo, Japan.

Tomomitsu Hirota

Division of Molecular Genetics, Research Center for Medical Science, The Jikei University School of Medicine, Tokyo, Japan.

Akihiro Hatano

Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.

Mika Nakano

Department of Otorhinolaryngology, Toho University Graduate School of Medicine, Tokyo, Japan; Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan.

Daiki Nakashima

Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.

Tsuguhisa Nakayama

Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University, Tochigi, Japan.

Mayumi Tamari

Division of Molecular Genetics, Research Center for Medical Science, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: mayumitamari@jikei.ac.jp.

Mamoru Yoshikawa

Department of Otorhinolaryngology, Toho University Graduate School of Medicine, Tokyo, Japan; Department of Otorhinolaryngology, Toho University Ohashi Medical Center, Tokyo, Japan. Electronic address: mamoru.yoshikawa@med.toho-u.ac.jp.