A study on neutrophilic versus eosinophilic predominance in chronic rhinosinusitis patients

Abstract

Background: Rhinosinusitis is defined as a multifactorial disorder with persistence of symptoms caused by inflammation of the sinonasal mucosa for 12 or more weeks with confirmation by diagnostic nasal endoscopy and computed tomography. The main aim of this study is to analyze the neutrophilic or eosinophilic predominance among CRS patients with histopathological examination for appropriate management, and to understand the association between the endotypes of CRS and blood parameters. Materials and methods: A prospective cohort study was conducted on 137 patients over a period of two years at a tertiary centre. Diagnostic nasal endoscopy (DNE), computed tomography of the nose and paranasal sinus (CT PNS), complete haemogram (CBC), absolute eosinophil count (AEC), erythrocyte sedimentation rate (ESR), immunoglobulin E(IgE) was done. Patients were planned for functional endoscopic sinus surgery (FESS) and specimen was sent for histopathological examination. Results: The comparison between DNE and AEC groups showed statistical significance and so did the comparison between CT and IgE. When we compared the groups of CRS with and without polyps with DNE and CT, there was no statistical significance. Also 64.2% of patients had an eosinophilic predominance. Conclusion: It has also been reported that CRS are highly eosinophilic, also have substantial levels of neutrophils. Importantly, tissue neutrophilia has been associated with a poor response to corticosteroid therapy in patients with CRS with nasal polyps.

Keywords

• nasal polyp
• eosinophils
• neutrophils
• sinusitis
• allergy
• asthma
• inflammation