Our Summary

This research paper is about a study conducted on 30 patients who underwent surgery for nasal polyps - growths in the lining of the nose that can cause various symptoms like a blocked nose, runny nose, and loss of smell. The study aimed to understand if there were any factors that could help predict which patients would experience a return of their nasal polyps after surgery.

The scientists removed and analyzed the polyps to measure certain substances, specifically IL-5, IgE, vascular endothelial growth factor, and eosinophilic infiltration - these are all related to the immune system and inflammation. They then compared these measurements to the patients’ CT scans taken before the operation and their reported symptoms two years after surgery.

The study found that patients with high levels of eosinophilic infiltration - a type of white blood cell usually involved in fighting off infections and in allergic reactions - in their polyps were more likely to have their polyps return after surgery. High IL-5 (a protein involved in controlling the behavior of eosinophils) in the polyps also suggested an increased risk of recurrence, but the results were not statistically significant. On the other hand, the levels of IgE and vascular endothelial growth factor in the polyps did not seem to affect whether the polyps returned or not. The severity of the disease before the operation, as shown by the CT scans, had a slight correlation with a worse outcome after surgery.

In simple terms, this study suggests that if there’s a high level of certain white blood cells in your nasal polyps, you might be more likely to have the polyps come back after surgery. The severity of the disease before surgery might also affect how well you do after the operation.

FAQs

  1. Does high eosinophil infiltration in nasal polyps indicate a higher risk of recurrence after surgical removal?
  2. Can preoperative CT scores predict the clinical outcome after nasal polyp surgery?
  3. Do IgE and VEGF reactivity in nasal polyp specimens have any effect on polyp recurrence after surgery?

Doctor’s Tip

A doctor might advise a patient that high eosinophil infiltration in nasal polyps can predict a higher risk for polyp recurrence after surgical treatment. It is important to monitor and manage inflammation to potentially improve outcomes. Additionally, the extent of disease measured by a preoperative CT score may have a slight correlation with post-surgical outcomes. Regular follow-up appointments and monitoring of symptoms are important for early detection and management of any potential recurrence.

Suitable For

Patients with chronic rhinosinusitis with nasal polyposis who have high eosinophil infiltration in their polyps may be recommended for nasal polyp removal. Additionally, patients with high levels of IL-5 positivity may also be considered for surgery, as they may have a greater risk for polyp recurrence. Patients with high levels of IgE and VEGF reactivity in their polyps may not necessarily benefit from surgery, as these factors do not appear to have a significant impact on polyp recurrence. It is important to consider the extent of disease measured by CT score when recommending nasal polyp removal, as a higher score may be associated with a worse outcome after surgery.

Timeline

  • Before nasal polyp removal:
  1. Patient experiences symptoms such as nasal congestion, runny nose, postnasal drip, decreased sense of smell, and facial pressure or pain.
  2. Patient may undergo diagnostic tests such as nasal endoscopy, CT scan, or allergy testing to confirm the presence of nasal polyps.
  3. Treatment may include medications such as corticosteroids to reduce inflammation and shrink the polyps.
  4. If conservative treatment is ineffective, patient may be recommended for nasal polyp removal surgery.
  • After nasal polyp removal:
  1. Patient undergoes nasal polyp removal surgery, which may be performed endoscopically or through traditional open surgery.
  2. Removed polyps are analyzed for markers such as IL-5, IgE, and VEGF to predict recurrence and clinical outcome.
  3. Patients are followed up postoperatively to monitor for symptom improvement and potential recurrence.
  4. High eosinophil infiltration in polyps is found to be a predictor of higher risk for polyp recurrence.
  5. High IL-5 positivity is associated with a greater risk for polyp recurrence, while IgE and VEGF reactivity do not have a significant impact on recurrence.
  6. Preoperative CT score is slightly correlated with subjective score improvement after 2 years, indicating that the extent of disease may influence the outcome of surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with nasal polyp removal surgery?
  2. How long is the recovery period after nasal polyp removal surgery?
  3. Will I need any follow-up appointments or care after the surgery?
  4. What can I do to help prevent the recurrence of nasal polyps after surgery?
  5. How will the surgery affect my ability to breathe through my nose?
  6. Will I need any medications or treatments after the surgery to manage symptoms or prevent recurrence?
  7. How will the surgery impact my sense of smell and taste?
  8. Are there any lifestyle changes or precautions I should take after nasal polyp removal surgery?
  9. How soon can I expect to see improvements in my symptoms after the surgery?
  10. Are there any alternative treatments or therapies available for nasal polyps that I should consider before opting for surgery?

Reference

Authors: Grgić MV, Ćupić H, Kalogjera L, Baudoin T. Journal: Eur Arch Otorhinolaryngol. 2015 Dec;272(12):3735-43. doi: 10.1007/s00405-015-3519-7. Epub 2015 Jan 30. PMID: 25634061