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Piszczatowska K, Czerwaty K, Dżaman K, Jermakow N, Brzost J, Kantor I, Ludwig N, Szczepański MJ. Evaluation of CNPase and TGFβ1/Smad Signalling Pathway Molecule Expression in Sinus Epithelial Tissues of Patients with Chronic Rhinosinusitis with (CRSwNP) and without Nasal Polyps (CRSsNP). J Pers Med 2024; 14:894. [PMID: 39338148 PMCID: PMC11433593 DOI: 10.3390/jpm14090894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/13/2024] [Accepted: 08/21/2024] [Indexed: 09/30/2024] Open
Abstract
Chronic rhinosinusitis with and without nasal polyps (CRSwNP and CRSsNP, respectively) is a chronic inflammatory disease affecting almost 5 to 12% of the population and exhibiting high recurrence rates after functional endoscopic sinus surgery (FESS). TGFβ1-related pathways contribute to tissue remodelling, which is one of the key aspects of CRS pathogenesis. Additionally, adenosine signalling participates in inflammatory processes, and CNPase was shown to elevate adenosine levels by metabolizing cyclic monophosphates. Thus, the aim of this study was to assess the expression levels of Smad2, pSmad3, TGFβ1, and CNPase protein via immunohistochemistry in sinus epithelial tissues from patients with CRSwNP (n = 20), CRSsNP (n = 23), and non-CRS patients (n = 8). The expression of Smad2, pSmad3, TGFβ1, and CNPase was observed in the sinus epithelium and subepithelial area of all three groups of patients, and their expression correlated with several clinical symptoms of CRS. Smad2 expression was increased in CRSsNP patients compared to CRSwNP patients and controls (p = 0.001 and p < 0.001, respectively), pSmad3 expression was elevated in CRSwNP patients compared to controls (p = 0.007), TGFβ1 expression was elevated in CRSwNP patients compared to controls (p = 0.009), and CNPase was decreased in CRSsNP patients compared to controls (p = 0.03). To the best of our knowledge, we are the first to demonstrate CNPase expression in the upper airway epithelium of CRSwNP, CRSsNP, and non-CRS patients and point out a putative synergy between CNPase and TGFβ1/Smad signalling in CRS pathogenesis that emerges as a novel still undiscovered aspect of CRS pathogenesis; further studies are needed to explore its function in the course of the chronic inflammation of the upper airways.
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Affiliation(s)
- Katarzyna Piszczatowska
- Department of Biochemistry, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.P.); (N.L.)
| | - Katarzyna Czerwaty
- Department of Otolaryngology, The Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (K.C.); (K.D.); (I.K.)
| | - Karolina Dżaman
- Department of Otolaryngology, The Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (K.C.); (K.D.); (I.K.)
| | - Natalia Jermakow
- Department of Hyperbaric Medicine, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland;
| | - Jacek Brzost
- The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Ireneusz Kantor
- Department of Otolaryngology, The Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (K.C.); (K.D.); (I.K.)
| | - Nils Ludwig
- Department of Biochemistry, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.P.); (N.L.)
| | - Mirosław J. Szczepański
- Department of Biochemistry, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.P.); (N.L.)
- Department of Otolaryngology, The Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (K.C.); (K.D.); (I.K.)
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Modée Borgström A, Mogensen H, Engmér Berglin C, Knutsson J, Bonnard Å. Occurrence of mucosa-affecting diseases of the upper airways in middle ear cholesteatoma patients: a nationwide case-control study. Eur Arch Otorhinolaryngol 2024; 281:4081-4087. [PMID: 38517544 PMCID: PMC11266238 DOI: 10.1007/s00405-024-08567-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/18/2024] [Indexed: 03/24/2024]
Abstract
PURPOSE Exploring a possible link between upper airway inflammation and the development of cholesteatoma by studying the association between mucosa-affecting diseases of the upper airways and cholesteatoma surgery. METHODS This is a nationwide case-control study of 10,618 patients who underwent surgery for cholesteatoma in Sweden between 1987 and 2018. The cases were identified in the National Patient Register and 21,235 controls matched by age, sex and place of residency were included from national population registers. Odds ratios (OR) and corresponding 95% confidence intervals were used to assess the association between six types of mucosa-affecting diseases of the upper airways and cholesteatoma surgery. RESULTS Chronic rhinitis, chronic sinusitis and nasal polyposis were more common in cholesteatoma patients than in controls (OR 1.5 to 2.5) as were both adenoid and tonsil surgery (OR > 4) where the strongest association was seen for adenoid surgery. No association was seen between allergic rhinitis and cholesteatoma. CONCLUSION This study supports an association between mucosa-affecting diseases of the upper airways and cholesteatoma. Future studies should aim to investigate the mechanisms connecting mucosa-affecting diseases of the upper airways and cholesteatoma formation regarding genetic, anatomical, inflammatory and mucosa properties.
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Affiliation(s)
- Agnes Modée Borgström
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
- Medical Unit of ENT, Hearing and Balance, Karolinska University Hospital, Stockholm, Sweden.
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Engmér Berglin
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit of ENT, Hearing and Balance, Karolinska University Hospital, Stockholm, Sweden
| | - Johan Knutsson
- Department of Otolaryngology, Västerås Hospital, Västerås, Sweden
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Region Västmanland, Centre for Clinical Research, Uppsala University, Västmanland Hospital, Västerås, Sweden
| | - Åsa Bonnard
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit of ENT, Hearing and Balance, Karolinska University Hospital, Stockholm, Sweden
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Sykopetrites V, Di Maro F, Sica E, Cristofari E. Acquired cholesteatoma after cochlear implants: case series and literature review. Eur Arch Otorhinolaryngol 2024; 281:1285-1291. [PMID: 37776344 DOI: 10.1007/s00405-023-08251-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/16/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE To assess the prevalence and management of acquired cholesteatoma after cochlear implantation in pediatric and adult patients. METHODS Retrospective case review of pediatric and adult cochlear implants (CI) followed at a tertiary referral center and literature review of acquired cholesteatoma after CI surgery, to identify its prevalence, cause, and treatment. RESULTS Nine pediatric CIs were diagnosed with cholesteatoma in seven patients after 6.4 ± 4 years from CI surgery, and two adults after 11.3 and 21.7 years from CI surgery. Thirty-four pediatric cases and 26 adult cases are described in the literature. Cholesteatoma has a prevalence of 0.54% in pediatric CIs, and 1.79% in adult CIs (case series and literature). Adult cases were diagnosed significantly later compared to pediatric cases (Mann-Whitney test, p = 0.0460). Three pediatric cholesteatomas were treated with conservative surgery and preservation of the CI; they all developed recurrent disease. The remaining pediatric cases underwent subtotal petrosectomy with simultaneous CI explantation and staged reimplantation. Only one case recurred. The adult cases underwent simultaneous subtotal petrosectomy, explantation, and reimplantation. Similarly, 33.3% of cases treated with conservative/reconstructive surgery in the literature required revision surgery or conversion to subtotal petrosectomy against 6.2% of subtotal petrosectomies in the literature. CONCLUSIONS Cholesteatoma after CI is a rare and late-onset complication of CIs. It is more prevalent in the adult CI population, although it affects children significantly earlier. The treatment of choice is subtotal petrosectomy and CI explantation with simultaneous or staged reimplantation.
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Affiliation(s)
- Vittoria Sykopetrites
- Department of Audiovestibology, ASST dei Sette Laghi, Via Lazio, 21100, Varese, VA, Italy.
| | - Flavia Di Maro
- Department of Audiovestibology, ASST dei Sette Laghi, Via Lazio, 21100, Varese, VA, Italy
| | - Eleonora Sica
- Department of Audiovestibology, ASST dei Sette Laghi, Via Lazio, 21100, Varese, VA, Italy
| | - Eliana Cristofari
- Department of Audiovestibology, ASST dei Sette Laghi, Via Lazio, 21100, Varese, VA, Italy
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Jeong J, Youk TM, Choi HS. Risk factors for middle ear cholesteatoma surgery based on Korean population data. Acta Otolaryngol 2024; 144:187-192. [PMID: 38753949 DOI: 10.1080/00016489.2024.2344818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/13/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Studies of risk factors for middle ear cholesteatoma surgery using population-based data are lacking. OBJECTIVES To investigate the risk factors for cholesteatoma surgery in adults based on population data from Korea. MATERIALS AND METHODS For this retrospective study, we used Korean National Health Insurance Service National Sample Cohort data. Patients who were 20 years or older and underwent mastoidectomy from 2006 through 2015 under the diagnostic codes of cholesteatoma were defined as patients with middle ear cholesteatoma surgery. The control group was comprised of the remaining database sample in 2006. Sociodemographic factors in 2006 and histories of medical diseases, allergic diseases, and chronic sinusitis from 2003 through 2005 were compared between cholesteatoma surgery and control groups. RESULTS A total of 459 patients underwent cholesteatoma surgery. In multivariate Cox regression analysis, age 40-59 years and residence in metropolitan cities and small- and medium-sized cities and counties were significant risk factors for cholesteatoma surgery whereas allergic rhinitis, asthma, atopic dermatitis, and chronic sinusitis were not significant risk factors for middle ear cholesteatoma surgery. CONCLUSIONS AND SIGNIFICANCE The present study found no evidence of associations between allergic diseases or chronic sinusitis and cholesteatoma surgery in adults.
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Affiliation(s)
- Junhui Jeong
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Tae Mi Youk
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyun Seung Choi
- Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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Calvo-Henriquez C, Di Corso E, Alobid I, Cantone E, Di Cesare T, Mullol J. Pathophysiological Link Between Chronic Rhinosinusitis and Ear Disease. Curr Allergy Asthma Rep 2023; 23:389-397. [PMID: 37395977 DOI: 10.1007/s11882-023-01072-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE OF REVIEW In the clinical practice, patients affected by chronic rhinosinusitis (CRS) commonly complain of otologic symptoms. This review aims to describe the available literature evidence assessing the relationship between CRS and ear illnesses published in the last 5 years. RECENT FINDINGS Available evidence suggests a higher prevalence of otologic symptoms in patients suffering from CRS, affecting up to 87% of patients. These symptoms may be related to Eustachian tube dysfunction, which improves after treatment for CRS. A few studies suggested a potential but not confirmed role of CRS in cholesteatoma, chronic otitis media, and sensorineural hypoacusis. A special type of otitis media with effusion (OME) may occur in patients with CRS, which seems to respond well to new biologic therapy. Ear symptoms appear to be highly prevalent in patients with CRS. So far, the available evidence is robust only for Eustachian tube dysfunction, which has been shown to be particularly impaired in CRS patients. Additionally, the Eustachian tube function appears to improve after treatment for CRS. Finally, interesting preliminary data were described for eosinophilic otitis media, as it appears to respond well to the treatment with biologics.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Eugenio Di Corso
- Unit of Otorhinolaryngology-Head and Neck Surgery, "A. Gemelli" Hospital Foundation IRCCS, Rome, Italy
| | - Isam Alobid
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - Elena Cantone
- Unit of Otorhinolaryngology, Department of Neuroscience, Reproductive and Odontostomatological Sciences, "Federico II" University Hospital, Naples, Italy
| | - Tiziana Di Cesare
- Unit of Otorhinolaryngology-Head and Neck Surgery, "A. Gemelli" Hospital Foundation IRCCS, Rome, Italy
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic Barcelona, Universitat de Barcelona, Barcelona, Spain
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Son DS, Cho MS, Kim DK. Chronic rhinosinusitis could increase the risk of cholesteatoma of middle ear. Int Forum Allergy Rhinol 2023; 13:168-171. [PMID: 35900051 DOI: 10.1002/alr.23065] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Dae-Soon Son
- School of Big Data Science, Data Science Convergence Research Center, Hallym University, Chuncheon, Republic of Korea
| | - Min Seob Cho
- School of Big Data Science, Data Science Convergence Research Center, Hallym University, Chuncheon, Republic of Korea
| | - Dong-Kyu Kim
- Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Department of Otorhinolaryngology - Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
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Brescia G, Frosolini A, Franz L, Daloiso A, Fantin F, Lovato A, de Filippis C, Marioni G. Chronic Otitis Media in Patients with Chronic Rhinosinusitis: A Systematic Review. Medicina (B Aires) 2023; 59:medicina59010123. [PMID: 36676746 PMCID: PMC9867000 DOI: 10.3390/medicina59010123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Introduction: Chronic otitis media (COM) and chronic rhinosinusitis (CRS) are two of the most common otolaryngological disorders. CRS and COM share pathophysiological mechanisms such as bacterial infection, biofilm, and the persistence of the obstruction state of ventilation routes. The purpose of this systematic review was to evaluate all available information on the association between COM and CRS. Methods: The protocol of this investigation was registered on PROSPERO in November 2022. Pubmed, Scopus, Web of Science, and Cochrane databases were systematically searched according to the PRISMA statement. Results: After the application of inclusion-exclusion criteria, four manuscripts with adequate relevance to this topic were included in the review. The study population consisted of 20,867 patients with a diagnosis of CRS, of whom 991 were also diagnosed with COM (4.75%). Conclusions: The included studies have shown that CRS has become significantly associated with COMas: a global inflammatory process that involves the epithelium in both the middle ear and upper airway. The identification of a relationship between CRS and COM may contribute to preventing chronic inflammatory conditions through the early management of the associated disease. Further, carefully designed studies are necessary to demonstrate the relationship between COM and CRS.
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Affiliation(s)
- Giuseppe Brescia
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35100 Padova, Italy
- ENT Unit, Surgical Department, Ospedali Riuniti Padova Sud, 35043 Monselice-Padova, Italy
| | - Andrea Frosolini
- Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
- Correspondence: (A.F.); (G.M.)
| | - Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35100 Padova, Italy
- Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
- Guided Therapeutics (GTx) International Scholarship Program, Techna Institute, University Health Network (UHN), Toronto, ON M5G2C4, Canada
| | - Antonio Daloiso
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35100 Padova, Italy
| | - Francesco Fantin
- Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
| | - Andrea Lovato
- Otolaryngology Unit, Vicenza Hospital, 36100 Vicenza, Italy
| | - Cosimo de Filippis
- Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35100 Padova, Italy
- Correspondence: (A.F.); (G.M.)
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Khaksari F, Dalili Kajan Z, Jalali MM, Khosravifard N. The Relationship Between Temporal Bone Pneumatization Pattern and Sinus Mucosal Thickness Grading on Computed Tomography Scans of Paranasal Sinuses. Indian J Otolaryngol Head Neck Surg 2022; 74:1532-1539. [PMID: 36452698 PMCID: PMC9702416 DOI: 10.1007/s12070-021-02665-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022] Open
Abstract
The relationship between temporal bone pneumatization (TBP) pattern and sinus mucous thickness grading on computed tomography scans of paranasal sinuses was investigated. In this cross-sectional study, a total of 200 temporal bones and paranasal sinuses were evaluated in CT scans of 100 patients with chronic sinusitis (CRS). The mucosal thickness of paranasal sinuses was classified into two groups (0-6 and 7-12) according to the Lund-Mackay (LM) staging system. Also, pneumatization patterns of petrous apex and perilabyrinthine regions were classified according to Jadvah et al. method. Data were analyzed using Chi-square and Fisher's exact tests. The most common pneumatization pattern in the petrous apex was pattern A (49.5%) and in the perilabyrinthine region was pattern B (50%). In the petrous apex, the highest frequencies of pattern A (51.7%) and pattern C (24.6%), among other pneumatization patterns, were found in score range of 7-12 and 0-6, respectively, which was statistically significant (P = 0.017). Although in the perilabyrinthine region, the highest frequencies of pattern A (24.1%) and pattern C (32.7%) were in LM score ranges of 7-12 and 0-6, respectively, no significant difference was found (P = 0.589). The petrous apex pneumatization decreases with an increase in the severity of CRS, which can be in response to the eustachian tube dysfunction and common pathogens with CRS. A similar relationship was also found in the perilabyrinthine region, although it was not statistically significant. No significant relationship between TBP and severity of CRS was found in the age and sex groups.
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Affiliation(s)
- Farnoosh Khaksari
- Department of Maxillofacial Radiology, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Dalili Kajan
- Research Center of Allergic Diseases of Nose and Sinuses, Department of Maxillofacial Radiology, Dental School, End of Professor Samii Blvd, Guilan University of Medical Sciences, Rasht, Iran
| | - Mir Mohammad Jalali
- Research Center of Allergic Diseases of Nose and Sinuses, Department of Otorhinology, Guilan University of Medical Sciences, Rasht, Iran
| | - Negar Khosravifard
- Dental Sciences Research Center, Department of Maxillofacial Radiology, Guilan University of Medical Sciences, Rasht, Iran
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Endotyping of Cholesteatoma: Which Molecular Biomarkers? A Systematic Review. J Pers Med 2022; 12:jpm12081347. [PMID: 36013295 PMCID: PMC9409631 DOI: 10.3390/jpm12081347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background: So far, no medical treatment is available for cholesteatoma (C) and the only effective therapy is complete surgical removal, but recurrence is common even after surgical treatment. While C is classically divided into two clinical phenotypes, congenital and acquired, only a few studies have focused on its potential biomarkers. This study aims to revise the literature to identify which biomarkers can define the endotype of C. Methods: We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process to identify published experimental articles about molecular biomarkers in C. Results: KGF and its receptor, MMP-9, KRT-1, KRT-10, and MIF might be considered biomarkers of recurrence, whereas Ki-67, TLR-4, RANKL, IL17, MMP-2, MMP-9, IL6, TNF-α, should be considered more specifically as biomarkers of bony erosion. Conclusions: These results are interesting especially from a prognostic point of view, nevertheless more studies are needed to search new biomarkers of C that could completely change not only the therapeutic standards of the disease, but also the clinical history of C itself in the era of precision medicine.
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Şahin MM, Sözmen Cılız D, Çayönü M, Kayalı Dinç S, Akbal Ş, Boynueğri S, Eryılmaz A. Magnetic Resonance Imaging of the Eustachian Tube and the Paratubal Structures in Patients with Unilateral Acquired Cholesteatoma. J Int Adv Otol 2020; 16:373-377. [PMID: 33136019 DOI: 10.5152/iao.2020.7508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES This study aimed to compare the Eustachian tube (ET) and the paratubal structures between the two sides in subjects with unilateral acquired cholesteatoma and a healthy contralateral ear to determine if there are anatomical differences. MATERIALS AND METHODS Of the 217 patients with cholesteatoma evaluated, 36 patients with unilateral cholesteatoma were included in the study. All of the patients had a healthy contralateral ear with no history of surgery. Nine different paratubal parameters were measured through contrast-enhanced magnetic resonance imaging (MRI). The measurements of the ear with cholesteatoma were compared with those of the healthy ear. RESULTS The bimucosal thickness of the ET lumen, the mucosal thickness of the pharyngeal orifice, the lengths and diameters of the tensor veli palatini muscle and the levator veli palatini muscle, the diameter of the pharyngeal orifice of the ET, the diameter of the lateral pharyngeal recess mucosal thickness, and the diameter between the posterior border of the inferior nasal concha and the pharyngeal orifice of the ET were measured in MRI scans. No statistically significant difference was observed between the healthy ear and the ear with cholesteatoma for any of the parameters measured (p>0.05). CONCLUSION We did not observe any anatomical differences in the measurements of the ET and the paratubal structures on MRI scans. Although ET dysfunction is considered to be the leading etiologic factor in acquired cholesteatoma, the ET and the paratubal structures may not exhibit an anatomic difference between the ear with cholesteatoma and the healthy contralateral ear.
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Affiliation(s)
- Muammer Melih Şahin
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Deniz Sözmen Cılız
- Department of Radiology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Melih Çayönü
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Seçil Kayalı Dinç
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Şeyda Akbal
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Süleyman Boynueğri
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Adil Eryılmaz
- Department of Otorhinolaryngology, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Vandersteen C, Castillo L, Roger C, Savoldelli C, Guevara N. Tubomanometry: An effective and promising assessment of Eustachian tube dysfunction in chronic rhinosinusitis patients. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:7-12. [PMID: 32620424 DOI: 10.1016/j.anorl.2020.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIMS Obstructive eustachian tube (ET) dysfunction involves otologic complications, including cholesteatoma, and requires specific treatment. A causal relationship between obstructive ET dysfunction and chronic rhinosinusitis has only been suspected so far. Tubomanometry (TMM) is a new tool in ET dysfunction diagnosis and description. It has mainly been studied in chronic otitis patients but never in chronic rhinosinusitis (CRS). The aim of this work was to obtain TMM results from a CRS patient population presenting clinical ET dysfunction. MATERIALS AND METHODS A prospective monocentric non-blinded study was performed between November 1 2015 and February 29 2016, involving all adult patients (>18 years; n=294) suffering from bilateral chronic rhinosinusitis who consulted at the rhinology unit at our referral ENT university center; 129 patients were included. An obstructive ET dysfunction clinical screening questionnaire (ETDQ-7) was obtained from all patients. When the mean ETDQ-7 score was≥2.1, a more extensive clinical assessment was performed including clinical maneuvers, otoscopy, transnasal endoscopy, audiometry, tympanometry and TMM for the diagnosis of ET dysfunction. RESULTS Forty-seven per cent (n=61) had a positive ETDQ-7, 64% (n=39) of which had pathologic tubomanometric results: thirty-two (52.5%) had obstructive ET dysfunction TMM results and the remaining 7 (11.5%) patients had patulous ET TMM results. CONCLUSIONS Tubomanometry is a promising new tool for the evaluation of ET dysfunction and could be added to clinical assessment of chronic rhinosinusitis patients.
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Affiliation(s)
- C Vandersteen
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31, Avenue de Valombrose, 06100 Nice, France.
| | - L Castillo
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31, Avenue de Valombrose, 06100 Nice, France
| | - C Roger
- Biostatistics Department, Hôpital de Cimiez, Centre Hospitalier Universitaire, Université Côte d'Azur, 4, Avenue Reine Victoria, 06000 Nice, France
| | - C Savoldelli
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31, Avenue de Valombrose, 06100 Nice, France
| | - N Guevara
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d'Azur, 31, Avenue de Valombrose, 06100 Nice, France
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Nien CW, Lee CY, Wu PH, Chen HC, Chi JCY, Sun CC, Huang JY, Lin HY, Yang SF. The development of optic neuropathy after chronic rhinosinusitis: A population-based cohort study. PLoS One 2019; 14:e0220286. [PMID: 31390351 PMCID: PMC6685625 DOI: 10.1371/journal.pone.0220286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/13/2019] [Indexed: 11/21/2022] Open
Abstract
Background To evaluate the risk of developing optic neuropathy (ON) in patient with both non-surgery and surgery-indicated chronic rhinosinusitis (CRS) via the national health insurance research database in Taiwan. Methodology/Principal findings 44,176 Patients with a diagnostic code of CRS was selected, which included 6,678 received functional endoscopic sinus surgery (FESS) regarded as the surgery-indicated CRS. Each individual in the study group was matched to two non-CRS patients by age and gender. The outcome was set as the occurrence of ON according to the diagnostic codes occurred after the index date. Poisson regression was used to calculate the adjusted relative risk (aRR) and conditional Cox proportional model was used to estimate the adjusted hazard ratio (aHR). There were 131 and 144 events of ON occurred in the study group and the control group respectively during the follow-up period. The whole study group, whether received FESS or not, demonstrated both significant aRR and aHR compared to the control group after adjusting demographic data, prominent ocular diseases, and systemic co-morbidities. In addition, both the aRR and aHR were higher in CRS patient received FESS than those with CRS but without FESS management. Conclusion The existence of CRS, especially the surgery-indicated CRS is a significant risk factor for the following ON using multivariable analysis.
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Affiliation(s)
- Chan-Wei Nien
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chia-Yi Lee
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Optometry, College of Medicine and Life Science, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Pei-Hsuan Wu
- Department of Otolaryngology–Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jessie Chao-Yun Chi
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Otorhinolaryngology Head and Neck Surgery, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Chinese Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hung-Yu Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Optometry, Chung Shan Medical University, Taichung, Taiwan
- Department of Exercise and Health Promotion, Chung Chou University of Science and Technology, Changhua, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail:
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Real-World Database Examining the Association between Sjögren's Syndrome and Chronic Rhinosinusitis. J Clin Med 2019; 8:jcm8020155. [PMID: 30704055 PMCID: PMC6406236 DOI: 10.3390/jcm8020155] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 01/22/2019] [Accepted: 01/26/2019] [Indexed: 02/07/2023] Open
Abstract
Objective: To investigate the risk of chronic rhinosinusitis (CRS) among patients with Sjögren’s syndrome (SS). Method: A total of 18,723 patients diagnosed with SS between 1997 and 2011 were retrospectively analyzed. Moreover, 59,568 patients without SS were matched to patients with SS at a 1:4 ratio on the basis of sex, age, urbanization level, income level, and the comorbidities of rhinitis and nasal sepal deviation. Patients were followed up until death or the end of the study period (31 December, 2013). The primary outcome was the occurrence of CRS. Results: The cumulative incidence of CRS was significantly higher in patients with SS than in those without SS (p < 0.001). The adjusted Cox proportional hazard model showed that patients with SS had a significantly higher incidence of CRS (hazard ratio, 2.51; 95% confidence interval, 2.22–2.84; p < 0.001). Sensitivity and subgroup analyses demonstrated SS was an independent risk factor for CRS. The dosage of intranasal corticosteroid spray used was not different between the SS and non-SS groups. Fewer patients with CRS in the SS group underwent sinus surgery (82/407 (20.2%)) than those in the non-SS group (179/667 (26.8%)) and this finding was statistically significant (p = 0.013). The number of operations did not differ significantly between patients with CRS in the SS and non-SS groups. Conclusions: SS is an independent risk factor for CRS. Our study extends the disease spectrum and prompts physicians to be aware of potential CRS occurrence after SS.
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