Histopathologic Characteristics of Chronic Sinusitis with Asthma

Dhong, Hun Jong; Ha, Byung Suk; Rho, Hyoung Il; Bang, Eun Guk; Lee, Chi Kyou

Abstract

BACKGROUND AND OBJECTIVES: Chronic sinusitis has been closely related to bronchial asthma. Patients with both sinusitis and asthma have showed somewhat different mucosal appearance and pathology, compared to those without asthma. We investigated histopathological features of these patients.
SUBJECTS AND METHOD
19 sinusitis patients with asthma who had undergone endoscopic sinus surgery from April, 1995 through September, 1997, and 53 patients without asthma who had undergone surgery from January, 1997 through July, 1997 were evaluated. We compared the following 7 parameters of sinus mucosal histopathology between the asthma and non-asthma group by reviewing histopathological slides: basement membrane thickening, goblet cell hyperplasia, subepithelial edema, submucous gland formation, eosinophilic infiltration, lymphocyte infiltration, polymorphonuclear leukocyte infiltration. We also compared preoperative disease extent, evaluated by degree of polyposis and OMC CT findings, and presence of allergy, which might affect the sinus mucosal pathology.
RESULTS
There revealed no statistical difference between two groups on presence of allergy, preoperative polyposis, and OMC CT scores. However, the asthma group showed significant basement membrane thickening, goblet cell hyperplasia, and eosinophilic infiltration, which was statistically significant. No difference was found between subepithelial edema, submucous gland formation, lymphocyte infiltration, and polymorphonuclear leukocyte infiltration.
CONCLUSION
Significant histopathological features such as basement membrane thickening, goblet cell hyperplasia, and eosinophil infiltration characterized chronic sinusitis with asthma; however, there were no differences owing to the presence of allergy or the extent of preoperative disease. Adequate preoperative management, close attention during surgery and careful follow-up would be necessary.