PURPOSE: We investigated the clinical factors (CT images, endoscopic nasal findings and allergic factors) involved in resistance of chronic sinusitis to macrolide therapy (ME) retrospectively. METHODS: ME was administered for 8-20 weeks in 68 adults with chronic sinusitis cases. The effect was evaluated in each factor from radiographic findings (R0-R3 according to the severity of the images), nasal findings (N0: no polyp, N1: a single polyp and N2: multiple polyps), allergic factors (A0: no allergy, A1: nasal allergy, A2: bronchial asthma) and objective nasal symptoms. In addition, an effect after polypectomy and histological examination were assessed for N1 and N2 groups. RESULTS: ME was effective in 70.6% (48/68 patients). The efficacy of ME was significantly less in the polyp group compared with the polyp-free group (p < 0.05). Therapeutic efficacy was significantly different between R1 and R3 groups (p < 0.05) with a tendency for worse outcome from R1 to R3. The efficacy in asthma patients was significantly less compared with patients with allergic rhinitis or no allergy (p < 0.05). The efficacy after polypectomy was significantly improved in N2 group but not in N1 group. The number of eosinophil/total inflammatory cells (%) in nasal polyps of resistant cases was significantly higher than in marked improved cases. CONCLUSION: The efficacy of ME was less in patients with polyposis; CT scans indicating severe findings, bronchial asthma and polyps with increased eosinophil infiltrations. Polypectomy resulted in significant improvement in the efficacy of ME.
PURPOSE: We investigated the clinical factors (CT images, endoscopic nasal findings and allergic factors) involved in resistance of chronic sinusitis to macrolide therapy (ME) retrospectively. METHODS:ME was administered for 8-20 weeks in 68 adults with chronic sinusitis cases. The effect was evaluated in each factor from radiographic findings (R0-R3 according to the severity of the images), nasal findings (N0: no polyp, N1: a single polyp and N2: multiple polyps), allergic factors (A0: no allergy, A1: nasal allergy, A2: bronchial asthma) and objective nasal symptoms. In addition, an effect after polypectomy and histological examination were assessed for N1 and N2 groups. RESULTS:ME was effective in 70.6% (48/68 patients). The efficacy of ME was significantly less in the polyp group compared with the polyp-free group (p < 0.05). Therapeutic efficacy was significantly different between R1 and R3 groups (p < 0.05) with a tendency for worse outcome from R1 to R3. The efficacy in asthmapatients was significantly less compared with patients with allergic rhinitis or no allergy (p < 0.05). The efficacy after polypectomy was significantly improved in N2 group but not in N1 group. The number of eosinophil/total inflammatory cells (%) in nasal polyps of resistant cases was significantly higher than in marked improved cases. CONCLUSION: The efficacy of ME was less in patients with polyposis; CT scans indicating severe findings, bronchial asthma and polyps with increased eosinophil infiltrations. Polypectomy resulted in significant improvement in the efficacy of ME.
Authors: Gargi Rai; Priyamvada Roy; Neelima Gupta; Sonal Sharma; Sajad Ahmed Dar; Mohammad Ahmed Ansari; V G Ramachandran; Shukla Das Journal: Indian J Otolaryngol Head Neck Surg Date: 2017-07-26
Authors: Yoshimasa Imoto; Atsushi Kato; Tetsuji Takabayashi; Whitney Stevens; James E Norton; Lydia A Suh; Roderick G Carter; Ava R Weibman; Kathryn E Hulse; Kathleen E Harris; Anju T Peters; Leslie C Grammer; Bruce K Tan; Kevin Welch; Stephanie Shintani-Smith; David B Conley; Robert C Kern; Shigeharu Fujieda; Robert P Schleimer Journal: J Allergy Clin Immunol Date: 2019-09-25 Impact factor: 10.793
Authors: P Zarogoulidis; N Papanas; I Kioumis; E Chatzaki; E Maltezos; K Zarogoulidis Journal: Eur J Clin Pharmacol Date: 2011-11-22 Impact factor: 2.953
Authors: Karen Head; Lee Yee Chong; Patorn Piromchai; Claire Hopkins; Carl Philpott; Anne G M Schilder; Martin J Burton Journal: Cochrane Database Syst Rev Date: 2016-04-26