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December 1995

Eosinophilia in Chronic Childhood Sinusitis

Author Affiliations

From the Departments of Otolaryngology—Head and Neck Surgery, Division of Pediatric Otolaryngology (Drs Baroody, Hughes, and Naclerio), Pathology (Drs McDowell and Hruban), and Radiology (Dr Zinreich), The Johns Hopkins University School of Medicine, Baltimore, Md. Drs Baroody and Naclerio are now with the Section of Otolaryngology—Head and Neck Surgery, The University of Chicago (Ill).

Arch Otolaryngol Head Neck Surg. 1995;121(12):1396-1402. doi:10.1001/archotol.1995.01890120054010

Objectives:  To quantify eosinophilia in sinus tissues obtained from children with chronic sinusitis and to correlate the degree of eosinophilia with history of asthma, allergy, cystic fibrosis, and preoperative computed tomographic (CT) scans.

Design:  Examination of surgical specimens from children who underwent functional endoscopic sinus surgery and controls.

Setting:  Tertiary care medical center.

Patients:  Thirty-four children who underwent functional endoscopic sinus surgery for chronic sinusitis refractory to medical treatment were divided into three groups: 13 with asthma, 11 without asthma, and 10 with cystic fibrosis. Normal sphenoid sinus mucosa was also obtained from six adults undergoing transsphenoidal hypophysectomies.

Main Outcome Measures:  Number of lamina propria and intraepithelial eosinophils in surgical specimens, allergic status, presence or absence of asthma, and CT scans obtained preoperatively.

Results:  There were significantly more lamina propria and intraepithelial eosinophils in the tissue of children with chronic sinusitis compared with normal sphenoid sinus mucosa. More eosinophils were counted in the tissues of patients with asthma and cystic fibrosis compared with patients without concomitant disease, but this did not reach statistical significance. Allergy status did not affect the degree of tissue eosinophilia. Eosinophilia did not correlate with severity of mucosal disease as assessed by CT scans.

Conclusions:  Tissue eosinophilia is a characteristic histologic feature of chronic sinusitis in children, especially those with asthma. The presence of allergy does not predict tissue eosinophilia. Furthermore, the degree of tissue eosinophilia does not correlate with the severity of mucosal thickening seen on CT scans.(Arch Otolaryngol Head Neck Surg. 1995;121:1396-1402)

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