EOSINOPHILIA IN CHRONIC CHILDHOOD SINUSITIS

Objectives: To quantify eosinophilia in sinus tissues obtained from ch ildren with chronic sinusitis and to correlate the degree of eosinophi lia with history of asthma, allergy, cystic fibrosis, and preoperative computed tomographic (CT) scans. Design: Examination of surgical spec imens 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 ch ronic sinusitis refractory to medical treatment were divided into thre e groups: 13 with asthma, 11 without asthma, and 10 with cystic fibros is. Normal sphenoid sinus mucosa was also obtained from six adults und ergoing transsphenoidal hypophysectomies. Main Outcome Measures: Numbe r of lamina propria and intraepithelial eosinophils in surgical specim ens, allergic status, presence or absence of asthma, and CT scans obta ined preoperatively. Results: There were significantly more lamina pro pria and intraepithelial eosinophils in the tissue of children with ch ronic sinusitis compared with normal sphenoid sinus mucosa. More eosin ophils 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: Tis sue eosinophilia is a characteristic histologic feature of chronic sin usitis in children, especially those with asthma. The presence of alle rgy does not predict tissue eosinophilia. Furthermore, the degree of t issue eosinophilia does not correlate with the severity of mucosal thi ckening seen on CT scans.