Chronic rhinosinusitis in young children differs from adults: a histopathology study |
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Authors: | Chan Kenny H Abzug Mark J Coffinet Laurent Simoes Eric A f Cool Carlene Liu Andrew H |
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Institution: | From Departments of Otolaryngology-Head and Neck Surgery, Pediatrics (Sections of Infectious Diseases and Allergy/Immunology) and Pathology, University of Colorado School of Medicine, The Children's Hospital, and National Jewish Medical and Research Center, Denver, Colorado; Service ORL, Hospital Central, Nancy, France; and Imperial College of Medicine, London, United Kingdom |
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Abstract: | ObjectiveA histopathologic study of children with chronic rhinosinusitis (CRS) was undertaken to compare the sinus mucosa in pediatric and adult CRS.Study designCRS has been defined as persistent or recurrent sinusitis symptoms for ≥12 weeks despite conventional medical therapy, with abnormal computed tomography of the maxillary sinuses. Maxillary mucosal biopsies were obtained from pediatric CRS subjects for inflammatory cell and morphologic studies. Archival sinus mucosal tissues from adults with CRS were used as histologic controls. Sinus lavages were performed on children with and without CRS for microbiologic studies.ResultsSinus mucosal biopsies were obtained from 19 children with CRS (median age, 3.0 years; range 1.4-8.2 years). Pediatric CRS biopsies, as compared with adult CRS controls, had a higher density of submucosal lymphocytes (median 469 versus 294 cells/mm2 per 5 high-power fields HPF]; P = .02), lower density of submucosal eosinophils (medians 13 versus 82 cells/mm2 per 5 HPF; P = .01), thinner and more intact epithelium (P = .01 and .07, respectively), thinner basement membranes (P = .002), and fewer submucosal mucous glands (P = .004).ConclusionThe sinus mucosa of young children with CRS has less eosinophilic inflammation, basement membrane thickening, and mucus gland hyperplasia characteristic of adult CRS. |
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Keywords: | CFU Colony-forming unit CRS Chronic rhinosinusitis H& E Hematoxylin and eosin (staining) HPF High-powered field MBP Major basic protein |
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