Scientific Oral Presentations: Pathohysiology and Mechanisms
ARS073 - Histopathologic differences in adult and pediatric patients with chronic rhinosinusitis
Friday, April 29, 2022
10:36 AM – 10:42 AM CT
Location: Reunion Ballroom C
Hannah Brown, BS; Veena Ganesan; Pedro Escobedo, MS3; Peter Filip, MD; Anatoli Karas; Jill Jeffe; Peter Papagiannopoulos, MD; Pete Batra, MD, FARS; Bobby Tajudeen, MD, FARS
Fellow in Rhinology and Skull Base Surgery Rush University
Background: Adult and pediatric patients with chronic rhinosinusitis (CRS) generally undergo similar management. Few studies have undertaken sinonasal tissue-level comparisons of these groups. This study examines potential histopathologic differences between children and adults with CRS, with the goal of optimizing medical management.
Methods: In a retrospective cohort of CRS patients who underwent functional endoscopic sinus surgery (FESS), demographic factors, pertinent comorbidities, and a structured histopathologic report of 13 variables were compared across pediatric(≤18 years) and adult CRS patients with and without nasal polyps (pCRSwNP, pCRSsNP, aCRSwNP, aCRSsNP, respectively).
Results:411 adult (202 aCRSsNP, 209 aCRSwNP) and 55 pediatric(30 pCRSsNP, 25 pCRSwNP) patients were analyzed. Significantly more children compared to adults had a comorbid asthma diagnosis (62.9% vs. 35.5%, p=0.002). Regarding histopathologic characterization, adults with CRS exhibited significantly more tissue neutrophilia (30.3% vs. 11.5%, p=0.002), basement membrane thickening (70.2% vs. 44.3%, p<0.001), subepithelial edema (61% vs. 28.8%, p<0.001), squamous metaplasia (23.5% vs. 3.8%, p<0.001), and eosinophil aggregates (21.1% vs. 3.8%, p<0.001), than children with CRS. The majority of adult CRS patients exhibited a lymphoplasmacytic predominant inflammatory background, whereas the majority of children with CRS exhibited a lymphocyte predominant inflammatory background.
Conclusion: Sinonasal tissue of adult and pediatric CRS patients demonstrates clear histopathologic differences. Our findings provide insight into differing pathophysiology, which may enable optimization of targeted therapies for patients in each of these unique clinical groups.