Nasal-sinus polyposis: clinical-cytological grading and prognostic index of relapse

This longitudinal and prospective study aimed at investigating the influence of some parameters,including nasal cytology and clinical findings (such as asthma, atopy, acetylsalicylic acid (ASA) sensitivity, ASA associated with asthma), as risk factor of post-surgical relapse of nasal-sinus polyps. One hundred sixty-one consecutive patients (92 males and 69 females, mean age 47 years), affected by bilateral nasal polyposis and who had undergone surgical nasal polypectomy (endoscopic FESS), were examined post-surgically at least every 6 months for a period of 10 years. Endoscopic exam and nasal cytology exam were carried out on all patients and their case histories were carefully examined. The association eosinophilic-mast cell cellularity and the contemporary presence of asthma + ASA sensitivity showed the highest level of relapse (OR 4.5). In conclusion, cytological data in association with certain clinical parameters can predict a high risk prognosis of relapse.

Non-allergic rhinitis with eosinophils and mast cells constitutes a new severe nasal disorder

Three main types of inflammatory Non-Allergic Rhinitis (NAR) have been defined: NAR infiltrated by eosinophils (NARES), by mast cells (NARMA), and by neutrophils (NARNE). A new particular type has been characterized with current infiltration by eosinophils and mast cells (NARESMA). The aim of this study is to evaluate the clinical and functional characteristics in patients with NARES, NARMA, NARNE, and NARESMA and to define the latter. One hundred and seventy-six NAR patients were prospectively and consecutively evaluated: 52 patients with NARES, 38 with NARMA, 36 with NARNE, and 50 with NARESMA. Clinical features, Quality of Life (QoL), and rhinomanometry were evaluated in all of them. QoL was significantly different in the 4 groups. NARESMA patients had the worst QoL. Nasal function and QoL in NARESMA patients were significantly correlated. Significant associations were shown with both nasal polyps and asthma in NARESMA patients. This study provides the first evidence that NARESMA constitutes a new type of NAR and is a particularly severe disorder.

Quality of life in non-allergic rhinitis depends on the predominant inflammatory cell type

Three main types of inflammatory Non-Allergic Rhinitis (NAR) have been defined: NAR infiltrated by eosinophils (NARES), by mast cells (NARMA), and by neutrophils (NARNE). In the absence of studies that investigated the Quality of Life (QoL) in NAR, the present work is aimed at evaluating the Quality of Life of patients with NARES, NARMA, and NARNE. One hundred thirty one (131) NAR patients were prospectively and consecutively evaluated: 54 patients with NARES, 38 with NARMA, and 39 with NARNE. Their history, nasal infiltration and rhinomanometry were characterized, and Quality of Life (using 2 instruments) was evaluated, and associated to clinical and histological features. Quality of Life was significantly different in the 3 groups (p less than 0.001); NARES patients had the worst Quality of Life. Nasal resistances were significantly higher in the NARES group. Significant associations were shown in NARES patients between Quality of Life and nasal function. This study provides the first evidence that Quality of Life is impaired in NAR as well as in allergic rhinitis. Furthermore, Quality of Life impairment differs among the various forms of NAR, and there is a correlation with the cellular infiltrating type.