Abstract
Objective: Systemic eosinophilia strongly linked to serious
condition and poor prognosis in chronic rhinosinusitis with nasal polyps
(CRSwNP). We aimed to explore the relationship between systemic
eosinophilia and the features of paranasal sinus CT in CRSwNP.
Study design: Retrospective study.
Setting: A regional medical center in Guangzhou, China.
Participants: Patients suffered from CRSwNP under endoscopic
sinus surgery from January 2015 to December 2017.
Main outcome measures: Patients in this cohort were classified
into high blood eosinophils (B-high) and low blood eosinophils (B-low)
subgroups with a cutpoint of 0.3×109/L. Clinical
parameters, sinus Lund-Mackay (L-M)
score and olfactory cleft (OC) scores were analyzed in both two
subgroups.
Results: The treatment outcome was poorer in the B-high
subgroup, and in which preoperative sinus L-M CT score and tissue
eosinophil number were higher. B-Low subgroup showed lower concomitant
rate of allergic rhinitis and asthma. What’s more, OC score, ethmoid
sinus (ES) score, posterior ethmoid sinus (PES) score, sphenoid sinus
(SS) score, ethmoid sinus score/maxillary sinus score (ES/MS) ratio and
posterior ethmoid sinus score/anterior ethmoid sinus score (PES/AES)
ratio were significantly higher in the B-high subgroup. Logistic
regression analyses disclosed
that
comparing with other sinus CT parameters, OC score was an independent
predictor for systemic eosinophilia. There was a moderate correlation
between OC score and the level of blood eosinophil (r=0.57,P <0.001).
Conclusion: Olfactory
cleft opacification shown in paranasal sinus CT may be a marker for the
phenotype of CRSwNP with systemic eosinophilia, which appears to be
closely related to olfactory dysfunction.
Keywords: Nasal polyps; Systemic eosinophilia; Computed
tomography; Olfactory cleft opacification; Association;