1
|
Sagandykova K, Papulova N, Azhenov T, Darbekova A, Aigozhina B, Lechien JR. Endoscopic Features of Chronic Rhinosinusitis in Patients with Gastroesophageal Reflux Disease. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1257. [PMID: 39202538 PMCID: PMC11356763 DOI: 10.3390/medicina60081257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 07/12/2024] [Accepted: 07/26/2024] [Indexed: 09/03/2024]
Abstract
Chronic rhinosinusitis (CRS) is a complex inflammatory condition affecting the nasal and paranasal sinus mucosa. Gastroesophageal reflux disease (GERD) has been implicated as a potential exacerbating factor in CRS, but the specific endoscopic features of nasopharyngeal pathology in this context remain poorly understood. Background and Objectives: Chronic rhinosinusitis is a multifactorial disease with various underlying etiologies, including inflammation, anatomical factors, and environmental triggers. While gastroesophageal reflux disease has been suggested as a potential contributor to chronic rhinosinusitis, the specific endoscopic features indicative of nasopharyngeal pathology in CRS patients with GERD symptoms have not been clearly elucidated. Our aim is to identify specific endoscopic features of nasopharyngeal pathology in patients with CRS associated with GERD symptoms and to propose a method for assessing the influence of gastroesophageal reflux disease on the mucosal layer of the nose and nasopharynx. Materials and Methods: We conducted a cross-sectional observational study involving 521 adult patients presenting with symptoms suggestive of CRS. From this cohort, 95 patients with the highest scores on the Reflux Symptom Index (RSI) and Reflux Symptom Score-12 (RSS-12) questionnaires were selected as the main group. Endoscopic examinations were performed to assess the nasal and nasopharyngeal mucosa. Results: Our study revealed significant alterations in the nasopharyngeal mucosa of patients with CRS associated with GERD symptoms. Increased vascularity of the nasopharyngeal mucosa was observed in 91 patients (95.7%), while hypertrophy was noted in 83 patients (87.4%). Mucus was present in the nasopharynx of 77 patients (81.1%), exhibiting varying characteristics of color and consistency. Asymmetric hypertrophy of the oropharyngeal mucosa was noted in 62 patients (65.3%). Conclusions: We propose a method for assessing the influence of gastroesophageal reflux disease on the mucosal layer of the nose and nasopharynx, which may aid in diagnostic and management decisions. Further research is warranted to explore the potential impact of GERD symptoms on the course and severity of CRS exacerbations.
Collapse
Affiliation(s)
- Kalamkas Sagandykova
- “University Medical Center” Corporate Fund, School of Medicine, Nazarbayev University (NUSOM), Astana 010000, Kazakhstan
- Department of Otorhinolaryngology, NpJSC “Astana Medical University”, Astana 010000, Kazakhstan; (N.P.); (T.A.); (B.A.)
| | - Nataliya Papulova
- Department of Otorhinolaryngology, NpJSC “Astana Medical University”, Astana 010000, Kazakhstan; (N.P.); (T.A.); (B.A.)
| | - Talapbek Azhenov
- Department of Otorhinolaryngology, NpJSC “Astana Medical University”, Astana 010000, Kazakhstan; (N.P.); (T.A.); (B.A.)
| | - Aliya Darbekova
- Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Astana 010000, Kazakhstan;
| | - Bayan Aigozhina
- Department of Otorhinolaryngology, NpJSC “Astana Medical University”, Astana 010000, Kazakhstan; (N.P.); (T.A.); (B.A.)
| | - Jerome R. Lechien
- Laryngopharyngeal Reflux Study Group, Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), 13005 Paris, France;
- Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, 78180 Paris, France
- School of Medicine, University Paris Saclay, 91190 Paris, France
| |
Collapse
|
2
|
Li W, Zhang Y, Li X, Xie M, Dong L, Jin M, Lu Q, Zhang M, Xue F, Jiang L, Yu Q. Causal association of gastroesophageal reflux disease with chronic sinusitis and chronic disease of the tonsils and adenoids. Eur Arch Otorhinolaryngol 2024; 281:2975-2984. [PMID: 38217725 DOI: 10.1007/s00405-023-08435-6] [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: 09/18/2023] [Accepted: 12/21/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Exploring bidirectional causal associations between gastroesophageal reflux disease (GERD) and chronic disease of the tonsils and adenoids and chronic sinusitis, respectively. METHODS We first conducted a TSMR (two-sample mendelian randomization) study using the results of the inverse variance weighting method as the primary basis and bidirectional MR to rule out reverse causation. Subsequently, MVMR (multivariate MR) analysis was performed to identify phenotypes associated with SNPs and to explore the independent effect of GERD on two outcomes. Finally, we calculated MR-Egger intercepts to assess horizontal polytropy and Cochran's Q statistic to assess heterogeneity and ensure the robustness of the study. RESULTS For each standard deviation increase in genetically predicted GERD rate, there was an increased risk of chronic disease of the tonsils and adenoids (OR 1.162, 95% CI 1.036-1.304, P: 1.06E-02) and of developing chronic sinusitis (OR 1.365, 95% CI 1.185-1.572, P: 1.52E-05), and there was no reverse causality. Causality for TSMR was obtained on the basis of IVW (inverse variance weighting) and appeared to be reliable in almost all sensitivity analyses, whereas body mass index may be a potential mediator of causality between GERD and chronic sinusitis. CONCLUSION There is a causal association between GERD and chronic disease of the tonsils and adenoids and chronic sinusitis, respectively, and the occurrence of GERD increases the risk of developing chronic disease of the tonsils and adenoids and chronic sinusitis.
Collapse
Affiliation(s)
- Weizhen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Yanan Zhang
- Department of Hand and Podiatric Surgery, Orthopedics Center, the First Hospital of Jilin University, Changchun, 130021, China
| | - Xinwei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Mengtong Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Lin Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Mengdi Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Qingxing Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Min Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Fengyu Xue
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Lintong Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China
| | - Qiong Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, China.
| |
Collapse
|
3
|
Taş BM, Bekin Sarıkaya PZ, Şencan Z, Cömert E, Bayar Muluk N. Radiological Evaluation of the Effect of Laryngopharyngeal Reflux on the Thickness of Inferior Turbinate, Maxillary Sinus Mucosa and Nasal Septal Body. Indian J Otolaryngol Head Neck Surg 2024; 76:530-535. [PMID: 38440497 PMCID: PMC10908712 DOI: 10.1007/s12070-023-04204-3] [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: 05/30/2023] [Accepted: 08/28/2023] [Indexed: 03/06/2024] Open
Abstract
Background We investigated the relationship between Laryngopharyngeal Reflux (LPR) and maxillary sinus mucosal thickness (MSMT), inferior turbinate mucosal thickness (ITMT), inferior turbinate width (ITW) and nasal septal body thickness (NSBT), which can be signs of chronic rhinosinusitis and allergic rhinitis. Methods The study, which included 87 patients, was designed as two groups. While 42 of the patients were included in the Laryngopharyngeal Reflux group, 45 were included in the control group. Age and gender information of the patients were noted. MSMT, ITMT, ITW and NSBT values were measured in patients who had Paranasal Sinus Computed Tomography. MSMT, ITMT and ITW were measured as right and left. Both groups were evaluated in terms of these values. Results Right ITMT, bilateral ITW and MSMT values were found to be significantly higher in the LPR group than in the control group (p < 0.05). MSMT values were higher in males (p < 0.05). The left-ITT and NSBT values were not significantly different between the LPR group and the control group, but both values were higher in the LPR group than in the control group (p > 0.05). In the LPR group, there were positive correlations between ITMT and ITW values of the right side; and left side separately (p < 0.05). Conclusion It has been shown that Laryngopharyngeal Reflux increases maxillary sinus mucosal thickness, inferior turbinate thickness and width, and nasal septal body thickness, which can be signs of chronic rhinosinusitis and allergic rhinitis. The negative effects of LPR on nasal and paranasal mucosa and structures were demonstrated in this study.
Collapse
Affiliation(s)
- Burak Mustafa Taş
- Faculty of Medicine, ENT Department, Kırıkkale University, Kırıkkale, Turkey
| | | | - Ziya Şencan
- Faculty of Medicine, ENT Department, Kırıkkale University, Kırıkkale, Turkey
| | - Ela Cömert
- Faculty of Medicine, ENT Department, Kırıkkale University, Kırıkkale, Turkey
| | - Nuray Bayar Muluk
- Faculty of Medicine, ENT Department, Kırıkkale University, Kırıkkale, Turkey
| |
Collapse
|
4
|
Bandi S, Stephen E, Bansal K, Mahdavinia M. Understanding the CRSwNP Patient as Whole. Am J Rhinol Allergy 2023; 37:140-146. [PMID: 36848278 DOI: 10.1177/19458924231152671] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Chronic rhinosinusitis with nasal polyps (CRSwNP) is a distinct inflammatory disease of the upper airways with a significant impact on the health and quality of life of affected patients. Several comorbid conditions such as allergic rhinitis, asthma, sleep disorders, and gastroesophageal reflux disease are commonly reported in patients with CRSwNP. OBJECTIVE In this article, we intended to review the UpToDate information on how these comorbidities can impact CRSwNP patients' health and well-being. METHODS A PUBMED search was performed to review relevant recent article on the topic. RESULTS While there have been significant advances in the knowledge and management options for CRSwNP in the past few years, additional studies are needed to understand the underlying pathophysiologic mechanisms of these associations. In addition, awareness of the impact of CRSwNP on mental health, quality of life, and cognition is paramount to treating this condition. CONCLUSION Recognition and addressing CRSwNP comorbidities such as allergic rhinitis, asthma, sleep disorders, gastroesophageal reflux disease, and cognitive function impairment are important to optimally understand and manage the patient with CRSwNP as a whole.
Collapse
Affiliation(s)
- Sindhura Bandi
- Division of Allergy/Immunology, Department of Internal Medicine, 2468Rush University Medical Center, Chicago, Illinois
| | - Ellen Stephen
- Division of Allergy/Immunology, Department of Internal Medicine, 2468Rush University Medical Center, Chicago, Illinois
| | - Keerthi Bansal
- Division of Allergy/Immunology, Department of Internal Medicine, 2468Rush University Medical Center, Chicago, Illinois
| | - Mahboobeh Mahdavinia
- Division of Allergy/Immunology, Department of Internal Medicine, 2468Rush University Medical Center, Chicago, Illinois
| |
Collapse
|
5
|
Laryngopharyngeal reflux, chronic rhinosinusitis and Nasopharyngeal pH monitoring. Auris Nasus Larynx 2022; 49:733-734. [DOI: 10.1016/j.anl.2022.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 12/14/2022]
|