Chronic rhinosinusitis in young children differs from adults: a histopathology study.
OBJECTIVE
A histopathologic study of children with chronic rhinosinusitis (CRS) was undertaken to compare the sinus mucosa in pediatric and adult CRS.


METHODS
CRS has been defined as persistent or recurrent sinusitis symptoms for >or=12 weeks despite conventional medical therapy, with abnormal computed tomography of the maxillary sinuses. Maxillary mucosal biopsies were obtained from pediatric CRS subjects for inflammatory cell and morphologic studies. Archival sinus mucosal tissues from adults with CRS were used as histologic controls. Sinus lavages were performed on children with and without CRS for microbiologic studies.


RESULTS
Sinus mucosal biopsies were obtained from 19 children with CRS (median age, 3.0 years; range 1.4-8.2 years). Pediatric CRS biopsies, as compared with adult CRS controls, had a higher density of submucosal lymphocytes (median 469 versus 294 cells/mm(2) per 5 high-power fields [HPF]; P=.02), lower density of submucosal eosinophils (medians 13 versus 82 cells/mm(2) per 5 HPF; P=.01), thinner and more intact epithelium (P=.01 and.07, respectively), thinner basement membranes (P=.002), and fewer submucosal mucous glands (P=.004).


CONCLUSIONS
The sinus mucosa of young children with CRS has less eosinophilic inflammation, basement membrane thickening, and mucus gland hyperplasia characteristic of adult CRS.
Chan
Kenny H
KH
Departments of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, The Children's Hospital, Denver, Colorado 80218, USA. chan.kenny@tchden.org
Abzug
Mark J
MJ
Coffinet
Laurent
L
Simoes
Eric A f
EA
Cool
Carlene
C
Liu
Andrew H
AH
D000328:Adult; D001485:Basement Membrane / Q000473:pathology; D001706:Biopsy; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004804:Eosinophils; D005088:Exocrine Glands / Q000473:pathology; D006801:Humans; D007223:Infant; D008214:Lymphocytes; D008443:Maxillary Sinus / Q000473:pathology*; D015523:Maxillary Sinusitis / Q000382:microbiology / Q000473:pathology* / Q000821:virology; D009297:Nasal Mucosa / Q000473:pathology*; D010950:Plasma Cells; D012220:Rhinitis / Q000382:microbiology / Q000473:pathology* / Q000821:virology