Hannah J Brown, Ali M Baird, Sarah Khalife, Pedro Escobedo, Peter Filip, Peter Papagiannopoulos, Paolo Gattuso, Pete Batra, Bobby A Tajudeen
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These cohorts of adult and elderly patients included patients with and without nasal polyps (NP).</p><p><strong>Results: </strong>Three hundred adult (158 aCRSsNP, 142 aCRSwNP) and 77 elderly (38 eCRSsNP, 39 eCRSwNP) patients were analyzed. Mean age of the adult cohort was 44.4 ± 12.4 years, while that of the elderly cohort was 71.9 ± 5.9 years (<i>P</i> <i><</i> <i>.001</i>). Significantly more adults compared to elderly individuals demonstrated a positive atopic status (79.7% vs 64.0%, <i>P</i> <i>=</i> <i>.004</i>). Elderly patients exhibited higher rates of comorbid diabetes mellitus than adult patients (21.6% vs 10.3%, <i>P</i> <i>=</i> <i>.009</i>). Adults exhibited more tissue eosinophilia (43.4% vs 28.6%, <i>P</i> <i>=</i> <i>.012</i>) and presence of eosinophil aggregates (25.0% vs 14.3%, <i>P</i> <i>=</i> <i>.029</i>) compared to elderly patients, regardless of NP status. Conversely, the elderly demonstrated significantly more fungal elements (11.7% vs 3.0%, <i>P</i> <i>=</i> <i>.004</i>), and trended toward increased overall inflammation (63.6% vs 55.3%, <i>P</i> <i>=</i> <i>.118</i>) and tissue neutrophilia (35.1% vs 27.3%, <i>P</i> <i>=</i> <i>.117</i>), compared to adults.</p><p><strong>Conclusion: </strong>Sinonasal tissue of adult and elderly patients with CRS demonstrates clear histopathological differences. Patient comorbidities, in addition to histopathological characterizations, may provide further context for management optimization.</p><p><strong>Level of evidence: </strong>2.</p><p><strong>Short summary: </strong>Sinonasal tissue samples from adult and elderly patients with CRS demonstrate clear histopathological differences. These patient populations also exhibit unique comorbidities. These distinctions have the potential to inform and optimize management of this condition.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Histopathological Differences in Adult and Elderly Patients With Chronic Rhinosinusitis.\",\"authors\":\"Hannah J Brown, Ali M Baird, Sarah Khalife, Pedro Escobedo, Peter Filip, Peter Papagiannopoulos, Paolo Gattuso, Pete Batra, Bobby A Tajudeen\",\"doi\":\"10.1177/19458924231172078\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Adult and elderly patients with chronic rhinosinusitis (CRS) undergo similar therapeutic management. Few studies have undertaken sinonasal tissue-level comparisons of these groups. This study examines histopathological differences between adults (>18, <65 years) and the elderly (≥65 years) with CRS, with the goal of optimizing medical management.</p><p><strong>Methods: </strong>In a retrospective cohort analysis, demographic factors, comorbidities, and a structured histopathological report of 13 variables were compared across adult and elderly patients with CRS who underwent functional endoscopic sinus surgery. These cohorts of adult and elderly patients included patients with and without nasal polyps (NP).</p><p><strong>Results: </strong>Three hundred adult (158 aCRSsNP, 142 aCRSwNP) and 77 elderly (38 eCRSsNP, 39 eCRSwNP) patients were analyzed. Mean age of the adult cohort was 44.4 ± 12.4 years, while that of the elderly cohort was 71.9 ± 5.9 years (<i>P</i> <i><</i> <i>.001</i>). Significantly more adults compared to elderly individuals demonstrated a positive atopic status (79.7% vs 64.0%, <i>P</i> <i>=</i> <i>.004</i>). Elderly patients exhibited higher rates of comorbid diabetes mellitus than adult patients (21.6% vs 10.3%, <i>P</i> <i>=</i> <i>.009</i>). Adults exhibited more tissue eosinophilia (43.4% vs 28.6%, <i>P</i> <i>=</i> <i>.012</i>) and presence of eosinophil aggregates (25.0% vs 14.3%, <i>P</i> <i>=</i> <i>.029</i>) compared to elderly patients, regardless of NP status. Conversely, the elderly demonstrated significantly more fungal elements (11.7% vs 3.0%, <i>P</i> <i>=</i> <i>.004</i>), and trended toward increased overall inflammation (63.6% vs 55.3%, <i>P</i> <i>=</i> <i>.118</i>) and tissue neutrophilia (35.1% vs 27.3%, <i>P</i> <i>=</i> <i>.117</i>), compared to adults.</p><p><strong>Conclusion: </strong>Sinonasal tissue of adult and elderly patients with CRS demonstrates clear histopathological differences. Patient comorbidities, in addition to histopathological characterizations, may provide further context for management optimization.</p><p><strong>Level of evidence: </strong>2.</p><p><strong>Short summary: </strong>Sinonasal tissue samples from adult and elderly patients with CRS demonstrate clear histopathological differences. These patient populations also exhibit unique comorbidities. 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引用次数: 2
摘要
背景:成人和老年慢性鼻窦炎(CRS)患者接受相似的治疗管理。很少有研究对这些组进行鼻窦组织水平的比较。方法:在回顾性队列分析中，比较了接受功能性内窥镜鼻窦手术的成人和老年CRS患者的人口统计学因素、合并症和结构化的组织病理学报告13个变量。这些成人和老年患者的队列包括有和没有鼻息肉(NP)的患者。结果:成人300例(aCRSsNP 158例，aCRSwNP 142例)，老年77例(eCRSsNP 38例，eCRSwNP 39例)。成人组平均年龄为44.4±12.4岁，老年组平均年龄为71.9±5.9岁(P .001)。与老年人相比，明显更多的成年人表现出阳性的特应性状态(79.7% vs 64.0%， P = 0.004)。老年患者合并糖尿病的比例高于成年患者(21.6% vs 10.3%， P = 0.009)。与老年患者相比，无论NP状态如何，成年人表现出更多的组织嗜酸性粒细胞(43.4%比28.6%，P = 0.012)和嗜酸性粒细胞聚集物(25.0%比14.3%，P = 0.029)。相反，与成年人相比，老年人表现出更多的真菌成分(11.7%比3.0%，P = 0.004)，总体炎症(63.6%比55.3%，P = 0.118)和组织中性粒细胞(35.1%比27.3%，P = 0.117)增加。结论:成人与老年CRS患者鼻窦组织有明显的组织病理学差异。患者的合并症，除了组织病理学特征，可能为管理优化提供进一步的背景。证据等级:2。摘要:成人和老年CRS患者的鼻窦组织样本显示出明显的组织病理学差异。这些患者群体也表现出独特的合并症。这些区别有可能为这种情况的管理提供信息和优化。
Histopathological Differences in Adult and Elderly Patients With Chronic Rhinosinusitis.
Background: Adult and elderly patients with chronic rhinosinusitis (CRS) undergo similar therapeutic management. Few studies have undertaken sinonasal tissue-level comparisons of these groups. This study examines histopathological differences between adults (>18, <65 years) and the elderly (≥65 years) with CRS, with the goal of optimizing medical management.
Methods: In a retrospective cohort analysis, demographic factors, comorbidities, and a structured histopathological report of 13 variables were compared across adult and elderly patients with CRS who underwent functional endoscopic sinus surgery. These cohorts of adult and elderly patients included patients with and without nasal polyps (NP).
Results: Three hundred adult (158 aCRSsNP, 142 aCRSwNP) and 77 elderly (38 eCRSsNP, 39 eCRSwNP) patients were analyzed. Mean age of the adult cohort was 44.4 ± 12.4 years, while that of the elderly cohort was 71.9 ± 5.9 years (P<.001). Significantly more adults compared to elderly individuals demonstrated a positive atopic status (79.7% vs 64.0%, P=.004). Elderly patients exhibited higher rates of comorbid diabetes mellitus than adult patients (21.6% vs 10.3%, P=.009). Adults exhibited more tissue eosinophilia (43.4% vs 28.6%, P=.012) and presence of eosinophil aggregates (25.0% vs 14.3%, P=.029) compared to elderly patients, regardless of NP status. Conversely, the elderly demonstrated significantly more fungal elements (11.7% vs 3.0%, P=.004), and trended toward increased overall inflammation (63.6% vs 55.3%, P=.118) and tissue neutrophilia (35.1% vs 27.3%, P=.117), compared to adults.
Conclusion: Sinonasal tissue of adult and elderly patients with CRS demonstrates clear histopathological differences. Patient comorbidities, in addition to histopathological characterizations, may provide further context for management optimization.
Level of evidence: 2.
Short summary: Sinonasal tissue samples from adult and elderly patients with CRS demonstrate clear histopathological differences. These patient populations also exhibit unique comorbidities. These distinctions have the potential to inform and optimize management of this condition.
期刊介绍：
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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