Chronic Disease ; Humans ; Nasal Polyps ; classification ; pathology ; Sinusitis ; classification ; pathology

Humans ; Nasal Cavity ; pathology ; Nasal Obstruction ; diagnosis ; Nasal Polyps ; diagnosis ; Turbinates

BACKGROUND AND OBJECTIVES: When the impairment of nasal airway patency in patients with chronic sinusitis such as mucosal edema or nasal polyps is resolved after functional endoscopic sinus surgery (FESS), it is expected that patients no longer complain of hyponasal voice. However, patients who have undergone FESS sometimes complain of more hyponasal voice, or thick voice. The purpose of this study was to examine the effect of FESS on voice in terms of nasality. MATERIALS AND METHODS: Thirty-three patients who underwent FESS and thirty normal adults who had no sinus or nasal pathology were selected for this study. We performed nasalance test for patients group before and 3 months after the operation and for the control group without any medication. RESULTS: Patients' preoperative mean nasalance were not low compared with that of control group in all sentences. It was different from perceptual hyponasality they had complained. Postoperative mean nasalance in patients showed statistically significant increase. Higher change ratio of nasalance was noted in Mamma passage than the other passages. CONCLUSION: There was significant increase in nasalance scores after FESS. Thus, we must consider the possibility of voice changes postoperatively in professional voice users.
Adult ; Edema ; Humans ; Nasal Polyps ; Pathology ; Sinusitis ; Voice

A case of rare intranasal hemangiopericytoma in a 68-year-old male was reported with typical histological and ultrastructural findings. The lesion clinically resembled a nasal polyp. The experience in the present case raised the need for differential diagnoses of vascularised spindle cell tumors and of traditional hemangiopericytoma in soft tissue.
Aged ; Diagnosis, Differential ; Hemangiopericytoma/diagnosis/*pathology ; Humans ; Male ; Nasal Cavity ; Nasal Polyps/diagnosis/*pathology ; Nose Neoplasms/diagnosis/*pathology

Objective: To identify the differentially expressed genes in nasal epithelial cells from chronic rhinosinusitis with nasal polyps (CRSwNP), and to analyze related genes which are involved in deficiency of nasal epithelial barrier in CRSwNP patients by analyzing the datasets download from the gene expression omnibus(GEO) database. Methods: The mRNA expression microarray data numbered GSE107624 (7 CRSwNP and 7 controls) and GSE69093 (13 CRSwNP and 11 controls) were downloaded from the publicly available GEO database. These two datasets were jointly analyzed to screen the differentially expressed genes in nasal epithelial cells of controls and CRSwNP patients. In the meanwhile, we further evaluated the function annotation and regulatory pathways of the differentially expressed genes. To further confirmed what we have observed, sinus tissues were collected from patients with CRSwNP (14 cases, 46.8±17.9 years) and uncinate process tissues were collected from patients with nasal septum deviation (7 cases, 23.4±2.3 years) as control group. The primary epithelial cells of nasal mucosa were cultured and the mRNA level of screened genes were measured by Q-PCR. SPSS 22.0 software was used to for statistical analysis. Results: GSE107624 dataset showed that there were 3 856 differentially genes in nasal epithelial cells between CRSwNP and control group, while there were 771 differentially expressed genes in GSE69093 dataset. Finally, 55 up-regulated genes and 3 down-regulated genes were noticed in nasal epithelial cells of CRSwNP patients in the two datasets. GO gene functional annotation analysis showed that SPTBN1, FNBP1L, VAPB and SNX1 were involved in cell adhesion function, MAP1B was participated in the formation of microtubule related complex. KEGG pathway enrichment analysis indicated that BAMBI and SIAH1 were involved in regulation of Wnt pathway, COL6A1 and EIF4E were involved in the regulation of PI3K-AKT pathway. String protein interaction network analysis assumed that MAP1B and VAPB were the core functional proteins. Among top 3 differentially expressed genes COL6A1, MAP1B and BAMBI, only MAP1B gene was increased in nasal epithelial cells of CRSwNP patients in comparison to controls. Conclusion: The increased MAP1B gene in epithelial cells of CRSwNP, as well as abnormal regulation of Wnt and PI3K-AKT signal pathways may mediate the barrier dysfunction in CRSwNP.
Chronic Disease ; Epithelial Cells ; Gene Expression Profiling ; Humans ; Nasal Mucosa/pathology* ; Nasal Polyps/pathology* ; Phosphatidylinositol 3-Kinases ; Rhinitis/pathology*

Aged ; Ethmoid Sinus ; pathology ; Female ; Humans ; Nasal Polyps ; complications ; Oculomotor Nerve Diseases ; complications ; Sphenoid Sinus ; pathology

OBJECTIVE: To study the expression of vascular endothelial growth factor(VEGF) and microvessel density (MVD), in nasal polyps and its significance. METHOD: The expression of VEGF, in nasal polyps from 50 patients and inferior turbinates from 10 patients were studied with immunohistochemical methods, measuring their grey score, the relations between expression microvessel density were analyzed. RESULT: (1) The differences between the VEGF expression in nasal polyp gland and vascular were significant (P < 0.05). (2) The differences between the microvessel quantities in nasal polyps and inferior turbinates were significant (P < 0.05). (3) The association between VEGF expression in vascular of nasal polyps and microvessel density was significant (r = -0.664 (< 0. 05). CONCLUSION In nasal polyps, VEGF, expression increased. Those results show that the abnormal expression of VEGF and MVD may play an impotent role in the development of nasal polyps. There was an important value for proper treatment and prediction of nasal polyps.
Humans ; Microvessels ; pathology ; Nasal Polyps ; metabolism ; pathology ; Neovascularization, Pathologic ; Vascular Endothelial Growth Factor A ; metabolism

Objective: To compare the clinical characteristics and plasma inflammatory markers levels in different endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP), and to explore the plasma biomarkers associated with endotypes of CRSwNP. Methods: A total of 74 CRSwNP patients (male/female: 41/33; average age: 40 years) and 40 control subjects underwent septoplasty in Tongji Hospital from January 2015 to December 2017 were enrolled in this study. The demographic and clinical features of all subjects including age, gender, past history, visual analogue scale (VAS) and CT scores were recorded. Patients with CRSwNP were divided into Eos^highNeu^high, Eos^highNeu^low, Eos^lowNeu^high and Eos^lowNeu^low four endotypes according to the eosinophil (Eos) percentage and neutrophil (Neu) count of nasal polyps tissue. Preoperative blood routine was performed and the levels of 27 biomarkers in plasma were measured by Bio-Plex suspension chip method. The clinical characteristics and the level of serum biomarkers of patients with different endotypes were compared. SPSS 18.0 software was used for statistical analysis. Results: There was no difference in the clinical features including gender ratio, age, course of disease, VAS score, endoscopy and CT score among Eos^highNeu^high, Eos^highNeu^low, Eos^lowNeu^high and Eos^lowNeu^low CRSwNP patients. Compared with Eos^lowNeu^high and Eos^lowNeu^low CRSwNP patients, patients with Eos^highNeu^high and Eos^highNeu^low endotype demonstrated a higher prevalence of atopy, allergic rhinitis and asthma comorbidity, and increased peripheral blood eosinophil absolute count and percentage (all P<0.05). However, there was no significant difference between Eos^highNeu^high and Eos^highNeu^low CRSwNP. Plasma levels of all 27 mediators including type 1 cytokines (IL-12 and IFN-γ), type 2 cytokines (IL-4, IL-5 and IL-13), type 3 cytokines (IL-17A), pro-inflammatory cytokines (IL-6 and TNF-α) and tissue remodeling-related markers (bFGF, VEGF and PDGF-BB) demonstrated no significant difference among all endotypes of CRSwNP (all P>0.05). Conclusions: Eos^high and Eos^low CRSwNP patients display significant differences regarding the prevalence of atopy, allergic rhinitis and asthma comorbidity, peripheral blood eosinophil absolute count and percentage, but the clinical characteristics, blood cellular and biological markers can not effectively distinguish four endotypes of CRSwNP. Further studies are warranted to dig out the potential objective, convenient and reliable markers associated with endotypes in patients with CRSwNP.
Adult ; Chronic Disease ; Eosinophils ; Female ; Humans ; Inflammation Mediators ; Male ; Nasal Polyps/pathology* ; Rhinitis/pathology* ; Sinusitis/complications*

OBJECTIVE: To investigate the application of endoscopic nasal lateral wall dissection in lesions of the maxillary sinus. METHOD: Ten hospitalized patients with the maxillary sinus lesions were treated with the endoscopic nasal lateral wall dissection. RESULT: All 10 patients were unilateral invasion. Among them, 7 cases were inverted papilloma, 2 cases were recurrent antrochoanal polyps, 1 case was sinusal tooth. The tumors and antrochoanal polyps originated from the every part of the maxillary sinus wall during operation, especially from the anterior and media wall. During 10-62 months follow-up,epithelization of nasal occured and the shape of inferior turbinate was well. All of them had no epiphora. CONCLUSION Endoscopic nasal lateral wall dissection can remain the function of nasal lacrimal duct and nasal cavity,and may provide a new minimally invasive approach for complete resection of lesions of nasal cavity and the maxillary sinus.
Dissection ; Endoscopy ; Humans ; Lacrimal Apparatus ; Maxillary Sinus ; pathology ; Nasal Cavity ; Nasal Polyps ; surgery ; Papilloma, Inverted ; surgery ; Turbinates

OBJECTIVE: To describe and analyze the clinical features of nasal respiratory epithelial adenomatoid hamartom and improve the levels of diagnosis and treatment. METHOD: Fourteen cases of nasal respiratory epithelial adenomatoid hamartom confirmed by pathology were collected and analyzed. RESULT: In 14 cases, primary complaint of Hyposmia(or Anosmia)and nasal obstruction were occured in 13 and 11 cases respectively. Four cases had past history of endoscopic sinus surgery because of the diagnosis of nasal polyps. Polypoid neoplasms could be seen in the bilateral olfactory clefts. Sinus CT showed soft tissue shadows in bilateral nasal cavity and mucous membrane thickening in different sinus. Endoscopic sinus surgery were utilized to eliminate focus in all cases. All cases weren t recurred after 2-20 months' following-up visitings. CONCLUSION Nasal respiratory epithelial adenomatoid hamartom is so rare that clinical and pathological doctors have limited knowledge of it. It has its own characteristics from the clinical symptoms, signs to sinus CT although they are nonspecific. So we should improve the understanding about it to avoid misdiagnosis or missed diagnosis.
Diagnosis, Differential ; Endoscopy ; Hamartoma ; diagnosis ; pathology ; surgery ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps ; Neoplasm Recurrence, Local ; Nose Neoplasms ; diagnosis ; pathology ; surgery ; Paranasal Sinuses