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;