title: Mucosal eosinophilia and recurrence of nasal polyps - new classification of chronic rhinosinusitis.
abstract: BACKGROUND
  Eosinophils and nasal polyps are believed to affect the surgical outcome of chronic rhinosinusitis (CRS). CRS is classified based on the presence of nasal polyps in western countries. The majority of patients with CRS with nasal polyps (CRS with NP) are characterized by predominantly eosinophilic inflammation. However, Asian patients with CRS with NP show characteristics indicative of neutrophilic inflammation. Therefore, are eosinophils or nasal polyps more important for the classification of CRS?
  
  
  METHODS
  A prospective cohort study conducted from April 2007 to March 2008 classified patients with CRS based on the presence of nasal polyps and mucosal eosinophilia. The recurrence rate of nasal polyps was compared between the groups. Recurrence rate was analysed as a time-dependent variable by the Kaplan-Meier method.
  
  
  RESULTS
  Eosinophilic inflammation was found in 59.6% of patients with CRS with NP. Patients with mucosal eosinophilia had higher polyp recurrence rate than patients without mucosal eosinophilia, whereas patients with nasal polyps did not have higher polyp recurrence rate than patients without nasal polyps.
  
  
  CONCLUSIONS
  Presence of mucosal eosinophilia is a more important factor than nasal polyps for classifying CRS in terms of the surgical outcome.
authors: Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan. nakayama-t@jikei.ac.jp
authors: T
authors: T
authors: Nakayama
authors: M
authors: M
authors: Yoshikawa
authors: D
authors: D
authors: Asaka
authors: T
authors: T
authors: Okushi
authors: Y
authors: Y
authors: Matsuwaki
authors: N
authors: N
authors: Otori
authors: T
authors: T
authors: Hama
authors: H
authors: H
authors: Moriyama
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004802:Eosinophilia / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa; D009298:Nasal Polyps / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012220:Rhinitis / Q000145:classification* / Q000453:epidemiology*; D012852:Sinusitis / Q000145:classification* / Q000453:epidemiology*