Comparison of Inflammatory Cell Profile and Th2 Cytokine Expression in the Ethmoid Sinuses, Maxillary Sinuses, and Turbinates of Atopic Subjects with Chronic Sinusitis

Chronic sinusitis is a common disease characterized by persistent inflammation of the sinus mucosa. This study was undertaken to investigate immunopathologic findings in biopsy specimens from the ethmoid sinuses, maxillary sinuses, and inferior nasal turbinates of 14 allergic subjects with chronic sinusitis. The composition of the inflammatory infiltrate in the three tissue sites was examined by immunocytochemistry with anti-CD3 (total T cells), anti-CD4 (helper T cells), anti-CD8 (suppressor T cells), anti-MBP (eosinophils), antitryptase (mast cells), and antichymase (mast cells) antibodies. These revealed a significant increase in the T-cell helper/suppressor ratio and eosinophils in the ethmoid sinus mucosa compared with those in the maxillary sinus mucosa and the inferior turbinate. Eosinophil numbers were also higher in the maxillary sinus than in the inferior turbinate. Mast cells were present in significantly higher numbers in the ethmoid sinus and inferior turbinate biopsy sections than in the maxillary sinus. With antisense, radiolabeled riboprobes, we used in situ hybridization to examine the expression of interleukin-4 and interleukin-5 transcripts. The density of cells expressing interleukin-4 transcripts was significantly higher in the inferior turbinate biopsy sections than in those from the ethmoid and maxillary sinuses. In addition, the number of interleukin-4 mRNA—positive cells was higher in the ethmoid than in the maxillary sinus mucosa. The density of interleukin-5 mRNA—positive cells was significantly higher in the ethmoid and maxillary sinuses than in the inferior turbinate. The results of this study indicate (1) a more intense inflammatory response in the ethmoid sinus than in the maxillary sinus and inferior turbinate in allergic chronic sinusitis and (2) different inflammatory responses in the upper airways that are dependent on the anatomic site. These findings have potential implications in the design of new therapeutic interventions for allergic chronic sinusitis. (Otolaryngol Head Neck Surg 1998;118:804–9.)

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ERRATUM. Mast cells and T cells in Kimura's disease express increased levels of interleukin-4, interleukin-5, eotaxin and RANTES

Clinical & Experimental Allergy ◽

10.1046/j.1365-2222.2003.01668.x ◽

2003 ◽

Vol 33 (4) ◽

pp. 538-538

Author(s):

Y. Kimura ◽

R. Pawankar ◽

M. Aoki ◽

Y. Niimi ◽

S. Kawana

Keyword(s):

T Cells ◽

Mast Cells ◽

Interleukin 4 ◽

Kimura’S Disease ◽

Interleukin 5

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Diagnostic Value of Nasal Cytology in Chronic Rhinosinusitis Assessed by a Liquid-based Cytological Technique

American Journal of Rhinology and Allergy ◽

10.1177/1945892418768581 ◽

2018 ◽

Vol 32 (3) ◽

pp. 181-187 ◽

Cited By ~ 7

Author(s):

Wenyu She ◽

Jun Yang ◽

Chengshuo Wang ◽

Luo Zhang

Keyword(s):

Maxillary Sinus ◽

Chronic Rhinosinusitis ◽

Inflammatory Cell ◽

Chronic Sinusitis ◽

Inferior Turbinate ◽

Inflammatory Cells ◽

Diagnostic Value ◽

Cell Counts ◽

Nasal Cytology ◽

Sinus Mucosa

Back ground: Nasal cytology has generally been employed as a useful diagnostic tool in the differentiation of rhinopathies. Objective The aim of this study was to assess the extent and diagnostic value of inflammation of nasal and paranasal sinus mucosa in chronic rhinosinusitis patients by employing a combination of nasal brushings and a liquid-based cytological technique. Methods Forty-eight patients with chronic sinusitis and 20 control subjects without any sign of sinusitis undergoing endoscopic surgery, although not all underwent endoscopic sinus surgery, were recruited to the study. Nasal cytology samples were collected from all subjects using nasal brush and processed a liquid-based cytological technique for evaluation of total and differential inflammatory cell counts. Biopsies were also taken from the inferior turbinates from its anterior margin in all subjects and from identical lateral maxillary sinus mucosa in patients with chronic sinusitis during surgery and routinely processed for staining and evaluation of inflammatory cells. Results Total and individual inflammatory cell counts in nasal brushings were significantly correlated with the respective inflammatory cell counts in biopsies obtained from the inferior turbinate (eosinophils: r = .519 and P = .016; neutrophils: r = .540 and P = .012; lymphocytes: r = .540 and P = .011) but not in biopsies obtained from the maxillary sinus. No correlation was observed between the inflammatory cells in biopsies from the inferior turbinate and biopsies from the maxillary sinus. The liquid-based cytological technique showed higher sensitivity (94.1%), specificity (76.9%), and positive predictive value (84.2%) for inflammation in the inferior turbinates than for inflammation in the maxillary sinus (sensitivity = 63.4% and positive predictive value = 63.4%). Conclusion Nasal cytology evaluated by use of nasal brushings processed by a liquid-based cytological technique is likely to have higher diagnostic value for the inflammatory response in noninfectious rhinitis than in chronic rhinosinusitis.

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Ciliary Activity of Nasal Polyp and Mucosa in Chronic Sinusitis

American Journal of Rhinology ◽

10.2500/105065891781874857 ◽

1991 ◽

Vol 5 (6) ◽

pp. 215-218 ◽

Cited By ~ 2

Author(s):

Hitoshi Saito ◽

Toshihito Tsubokawa

Keyword(s):

Maxillary Sinus ◽

Nasal Polyp ◽

Chronic Sinusitis ◽

Marked Decrease ◽

Inferior Turbinate ◽

Ciliary Activity ◽

Ciliary Beating ◽

Mucosal Cells ◽

Sinus Mucosa

Ciliary activity of mucosal cells of nasal polyps and the maxillary sinus mucosa in chronic sinusitis cultured in vitro were measured by a photoelectric method. The findings were compared with those of normal maxillary sinus and inferior turbinate mucosae. The ciliary beating of edematous type of nasal polyp, 955 ± 130 beats/min (mean ± SD), did not differ significantly from the normal control, whereas both the duration and rate of ciliary beating were significantly decreased with cystic and fibrous type polyps. Ciliary activity in chronic sinusitis was significantly inhibited in the order of fibrous, purulent, and edematous types. The total area of ciliated mucosa also was decreased and varied with the type of chronic sinusitis, showing the most marked decrease with fibrous type. The ciliary activity in chronic sinusitis showed impairment with respect to both decreased ciliary rate of beating and reduced ciliated area.

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Antigen-Specific IgE Antibody and Cytogram in Mucosa of the Nose and Sinus

American Journal of Rhinology ◽

10.2500/105065893781976410 ◽

1993 ◽

Vol 7 (3) ◽

pp. 111-115 ◽

Cited By ~ 4

Author(s):

Chia-Ming Liu ◽

Chia-Tung Shun ◽

Hue-Ching Song ◽

Shiann-Yann Lee ◽

Mow-Ming Hsu ◽

...

Keyword(s):

Mast Cells ◽

Plasma Cells ◽

Chronic Sinusitis ◽

Serum Levels ◽

Specific Ige ◽

Type I ◽

Ige Antibody ◽

Dust Mite ◽

Sinus Mucosa ◽

Maxillary Sinuses

Maxillary sinus mucosa from sinusitis patients (n = 60) and nasal mucosa from the inferior turbinates of hypertrophic rhinitis patients (n = 31) were collected to detect the appearance of tissue dust mite-specific IgE antibody and increase in eosinophils, mast cells, and plasma cells. The serum levels of total IgE and dust mite-specific IgE antibody were significantly greater in atopic patients than in nonatopic patients, whereas tissue specific IgE antibody was elevated in turbinate mucosa but not in sinus mucosa. Eosinophils and basophilic cells in epithelial scrapings from the inferior turbinates, assessed by Hansel stain, increased in about 85% of atopic patients with hypertrophic rhinitis (n = 16) and 60% of atopic patients with chronic sinusitis (n = 12). The increase in eosinophils, mast cells, and plasma cells was more prevalent in the turbinate mucosa of atopic patients than in that of nonatopics, but there was no such increase in sinus mucosa. We conclude that the maxillary sinuses may not be the target organ of type I allergic reaction and antigen-specific IgE antibody is probably produced by the local lymphoid tissue.

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Chronic Sinusitis: Comparison of Amoxicillin Concentration in Diseased versus Normal Mucosa

American Journal of Rhinology ◽

10.2500/105065896782159701 ◽

1996 ◽

Vol 10 (5) ◽

pp. 267-270

Author(s):

Philip D. Kooiker ◽

James M. Chow ◽

James A. Stankiewicz ◽

Ashok K. Singh

Keyword(s):

Medical Management ◽

Nasal Polyps ◽

Chronic Sinusitis ◽

Treatment Strategies ◽

Inferior Turbinate ◽

Normal Mucosa ◽

Ethmoid Sinus ◽

Current Medical ◽

Number Of Patients ◽

Sinus Mucosa

Despite advances in diagnostic and treatment strategies, chronic sinusitis remains both a common entity and a difficult disease to eradicate. Current medical management, which consists primarily of extended antibiotic therapy, is effective in temporarily alleviating symptoms, but is ineffective in a number of patients in eradicating the infection. One hypothesis for the failure of medical management may be due in part to inadequate penetration of antimicrobials into the diseased sinus mucosa. In order to investigate this, mucosal specimens consisting of nasal polyps and/or diseased anterior ethmoid mucosa were harvested from 19 patients with chronic sinusitis who were being treated with Augmentin® and analyzed for amoxicillin concentrations by high pressure liquid chromatography. A biopsy of normal-appearing mucosa from the inferior turbinate was obtained from the same patient and served as the control, and was analyzed for amoxicillin concentration. Nine of 14 (64%) patients who had polyps harvested had amoxicillin concentrations in the polyps less than the amoxicillin concentration in the inferior turbinate. Two of the 14 (14%) patients had amoxicillin concentrations in the polyps greater than the amoxicillin concentration in the inferior turbinate, and the remaining three patients had amoxicillin concentrations in the polyps similar to the amoxicillin concentration in the inferior turbinate, (P = 0.029). Five of the 10 (50%) patients who had diseased anterior ethmoid sinus mucosa had amoxicillin concentrations in the diseased anterior ethmoid sinus less than the amoxicillin concentration in the inferior turbinate. Two of the 10 (20%) patients had similar amoxicillin concentrations in the diseased anterior ethmoid sinus and in the inferior turbinate and three of 10 (30%) patients with diseased anterior ethmoid sinus mucosa had amoxicillin concentrations greater than the amoxicillin concentration in the inferior turbinate. (P = 0.3725). These data suggest that there is impaired penetration of amoxicillin into nasal polyps and possibly a trend toward impaired penetration of amoxicillin into diseased anterior ethmoid sinus mucosa.

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Mast cells and T cells in Kimura's disease express increased levels of interleukin-4, interleukin-5, eotaxin and RANTES

Clinical & Experimental Allergy ◽

10.1046/j.1365-2222.2002.01552.x ◽

2002 ◽

Vol 32 (12) ◽

pp. 1787-1793 ◽

Cited By ~ 32

Author(s):

Y. Kimura ◽

R. Pawankar ◽

M. Aoki ◽

Y. Niimi ◽

S. Kawana

Keyword(s):

T Cells ◽

Mast Cells ◽

Interleukin 4 ◽

Kimura’S Disease ◽

Interleukin 5

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Evaluating Endoscopic Ipsilateral Endonasal Corridor Approaches to the Anterolateral Wall of the Maxillary Sinus: A Computerized Tomography Study

International Archives of Otorhinolaryngology ◽

10.1055/s-0041-1724092 ◽

2021 ◽

Author(s):

Navarat Vatcharayothin ◽

Pornthep Kasemsiri ◽

Sanguansak Thanaviratananich ◽

Cattleya Thongrong

Keyword(s):

Confidence Interval ◽

Maxillary Sinus ◽

Inferior Turbinate ◽

Radial Access ◽

Sinus Wall ◽

Nasal Floor ◽

Significant Difference ◽

Anterolateral Wall ◽

The Mean ◽

Maxillary Sinuses

Abstract Introduction The endoscopic access to lesions in the anterolateral wall of the maxillary sinus is a challenging issue; therefore, the evaluation of access should be performed. Objective To assess the accessibility of three endoscopic ipsilateral endonasal corridors. Methods Three corridors were created in each of the 30 maxillary sinuses from 19 head cadavers. Accessing the anterolateral wall of the maxillary sinus was documented with a straight stereotactic navigator probe at the level of the nasal floor and of the axilla of the inferior turbinate. Results At level of the nasal floor, the prelacrimal approach, the modified endoscopic Denker approach, and the endoscopic Denker approach allowed mean radial access to the anterolateral maxillary sinus wall of 42.6 ± 7.3 (95% confidence interval [CI]: 39.9–45.3), 56.0 ± 6.1 (95%CI: 53.7–58.3), and 60.1 ± 6.2 (95%CI: 57.8–62.4), respectively. Furthermore, these approaches provided more lateral access to the maxillary sinus at the level of the axilla of the inferior turbinate, with mean radial access of 45.8 ± 6.9 (95%CI: 43.3–48.4) for the prelacrimal approach, 59.8 ± 4.7 (95% CI:58.1–61.6) for the modified endoscopic Denker approach, and 63.6 ± 5.5 (95%CI: 61.6–65.7) for the endoscopic Denker approach. The mean radial access in each corridor, either at the level of the nasal floor or the axilla of the inferior turbinate, showed a statistically significant difference in all comparison approaches (p < 0.05). Conclusions The prelacrimal approach provided a narrow radial access, which allows access to anteromedial lesions of the maxillary sinus, whereas the modified endoscopic Denker and the endoscopic Denker approaches provided more lateral radial access and improved operational feasibility on far anterolateral maxillary sinus lesions.

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