Clinicopathological Study of Chronic Paranasal Sinusitis: Comparison of Patients with and Without Asthma or Aspirin-Sensitive Asthma.:COMPARISON OF PATIENTS WITH AND WITHOUT ASTHMA OR ASPIRIN-SENSITIVE ASTHMA

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Some cases of chronic sinusitis have a poor outcome after endoscopic sinus surgery. Patients with asthma or aspirin-sensitive asthma have been reported to have a poor prognosis. We studied clinicopathological differences among cases with and without asthma or aspirin-sensitive asthma. The following factors were examined: preoperative CT findings, presence of infiltrating cells (eosinophils, neutrophils, lymphocytes and plasma cells) in the ethmoid sinus mucosa, number of eosinophils in the peripheral blood, and nasal polyp size. Eosinophil and plasma cell positivity, the number of eosinophils in the peripheral blood, and the size of nasal polyps were significantly different among the three groups. Eosinophil positivity was weakly corrected with both the number of eosinophils in the peripheral blood and the size of the nasal polyps in all patients. A strong correlation between eosinophil positivity in the ethmoid sinus mucosa and in the nasal polyps was also observed. In patients without asthma or aspirin-sensitive asthma, no significant correlations were observed.Patients without asthma who are positive for eosinophils in the ethmoid sinus mucosa are thought to have a local mechanism that results in eosinophil accumulation, while patients with asthma or aspirin-sensitive asthma are thought to have both local and general mechanisms of eosinophil accumulation.
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