Our Summary

This research study aimed to identify a predictor for the long-term recurrence of a chronic sinus disease with nasal polyps, known as Eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP). This condition often comes back even after treatment.

The researchers looked at data from 39 patients with Eos-CRSwNP who had their nasal polyps surgically removed more than once due to recurrence. They compared these patients to 49 similar patients who had no recurrence and 32 patients with a different type of the same disease.

The study focused on the numbers of two types of cells in the tissue of these polyps: eosinophils (a type of white blood cell) and lymphocytes (another type of white blood cell). They found that the number and proportion of eosinophils were highest in patients whose disease recurred and lowest in those with a different type of the disease. The reverse was true for lymphocytes.

They also found that the ratio of lymphocytes to eosinophils in the tissue, known as the LER, was significantly linked to the disease coming back and how long it took for it to return. If the LER was less than 0.67, it predicted that the disease would likely return after a long-term period with a good level of accuracy.

In simple terms, the study suggests that the balance of these two types of cells in the nasal polyps could be a useful sign to predict if and when this chronic sinus disease might come back after surgery.

FAQs

  1. What was the aim of this research study about Eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP)?
  2. What types of cells were focused on in this study and why were they significant in predicting the recurrence of the disease?
  3. What does the study suggest about the relationship between the balance of eosinophils and lymphocytes in nasal polyps and the likelihood of Eos-CRSwNP recurring after surgery?

Doctor’s Tip

Based on these findings, a doctor may advise a patient undergoing nasal polyp removal to monitor their symptoms closely and follow up regularly with their healthcare provider. They may also recommend additional treatments or interventions, such as corticosteroid nasal sprays or allergy management, to help reduce the risk of recurrence. It’s important for patients to communicate any changes or concerns with their doctor to ensure the best possible outcome and long-term management of their condition.

Suitable For

Patients with Eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP) who have had nasal polyps surgically removed more than once due to recurrence are typically recommended for nasal polyp removal. Additionally, patients with a high proportion of eosinophils and a low ratio of lymphocytes to eosinophils in their nasal polyp tissue may also be recommended for nasal polyp removal to prevent recurrence of the disease.

Timeline

Before nasal polyp removal:

  • Patient experiences symptoms of chronic sinusitis with nasal polyps, such as nasal congestion, runny nose, facial pain, and decreased sense of smell.
  • Patient may have tried various medications and treatments to manage symptoms, but the disease may have recurred multiple times.
  • Patient undergoes nasal endoscopy and imaging tests to confirm the presence of nasal polyps and assess the extent of the disease.
  • Patient discusses surgical options with an ENT specialist and decides to undergo nasal polyp removal.

After nasal polyp removal:

  • Patient undergoes nasal polyp removal surgery, which may be performed endoscopically.
  • Tissue from the removed nasal polyps is analyzed for the numbers and proportions of eosinophils and lymphocytes.
  • Researchers find that a low lymphocyte-to-eosinophil ratio (LER) in the tissue is associated with a higher likelihood of disease recurrence.
  • If the LER is less than 0.67, it predicts a higher chance of disease recurrence after a certain period of time.
  • This finding can help doctors predict the likelihood of chronic sinusitis with nasal polyps coming back and tailor treatment plans accordingly.

What to Ask Your Doctor

Some questions a patient should ask their doctor about nasal polyp removal in relation to this research study may include:

  1. Can you explain the significance of eosinophils and lymphocytes in the tissue of nasal polyps, and how does their balance affect the likelihood of recurrence of Eosinophilic chronic rhinosinusitis with nasal polyps (Eos-CRSwNP)?

  2. How will the ratio of lymphocytes to eosinophils (LER) in my nasal polyps be measured and what is considered a predictive ratio for recurrence according to this study?

  3. Based on this research, what are the potential implications for my long-term prognosis and risk of recurrence following nasal polyp removal surgery?

  4. Are there any specific follow-up recommendations or treatment options that should be considered based on the findings of this study?

  5. How can this information on cell composition in nasal polyps help personalize my treatment plan and improve the management of my Eosinophilic chronic rhinosinusitis with nasal polyps?

Reference

Authors: Wang J, Yang Y, Guo J, Yu P, Wang G, Liu X, Zhang Z, Li T, Zhang Y, Song X. Journal: Am J Rhinol Allergy. 2023 Sep;37(5):563-570. doi: 10.1177/19458924231179615. Epub 2023 Jun 4. PMID: 37271971