title: Predictors of respiratory epithelial adenomatoid hamartomas of the olfactory clefts in patients with nasal polyposis.
abstract: OBJECTIVE
  To look for predictors of respiratory epithelial adenomatoid hamartomas (REAH) development in patients operated for nasal polyposis (NP) by adjusting on confounding factors.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  One hundred and six patients with NP, endoscopically operated between September 2009 and March 2012 on the ethmoidal labyrinths and olfactory clefts, were enrolled in this study. Clinical data was collected 1 day prior to surgery by using a standard grid without knowledge of any histological features. Patients were then divided into two groups based on operative and pathological reports: with and without REAH in the olfactory cleft (REAH-OC). The multivariate logistic regression model was used to assess independent factors linked to the presence of REAH-OC in patients with NP.
  
  
  RESULTS
  The mean duration of NP disease in patients with REAH-OC was about 13.95 ± 10.8 years versus 5.7 ± 5.6 years in patients without REAH-OC (P < 0.0001). Seventy-four percent of patients with REAH-OC had undergone one or more NP-related surgeries in their lifetime, in contrast with 49.21% of patients without REAH-OC (P = 0.009). According to the multivariate logistic regression analysis, those patients experiencing NP ≥ 10 years (OR 4.0, 95% CI 1.304-12.062, P = 0.015) and those with asthma (OR 2.5, 95% CI 1.004-6.29, P < 0.05) were at an increased risk of developing REAH-OC.
  
  
  CONCLUSIONS
  The development of REAH in patients with NP appears as a specific disease of the mucosa of the OC, induced by a long-lasting and/or severe inflammation of the olfactory clefts.
  
  
  METHODS
  4.
authors.affiliation: Department of ENT-Head and Neck Surgery, University Hospital of Nancy, Nancy, France; Institut National de la Santé et de la Recherche Médicale (INSERM) CIC-EC CIE6, Nancy, France.
authors.forename: Duc T
authors.initials: DT
authors.lastname: Nguyen
authors.forename: Phi-Linh
authors.initials: PL
authors.lastname: Nguyen-Thi
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gauchotte
authors.forename: Fabien
authors.initials: F
authors.lastname: Arous
authors.forename: Jean M
authors.initials: JM
authors.lastname: Vignaud
authors.forename: Roger
authors.initials: R
authors.lastname: Jankowski
mesh_terms: D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D015331:Cohort Studies; D005260:Female; D006222:Hamartoma / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009298:Nasal Polyps / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D059747:Nasal Surgical Procedures / Q000379:methods; D009669:Nose Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D009830:Olfactory Bulb / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D020545:Respiratory Mucosa / Q000473:pathology; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D018570:Risk Assessment; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: Asthma; ethmoidal labyrinths; nasal polyposis; olfactory clefts; respiratory epithelial adenomatoid hamartomas