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Open, prospective, multicenter study on postoperative intranasal phototherapy in nasal polyposis

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

The therapeutic effect of ultraviolet (UV) light is generally attributed to its immunosuppressive and immunomodulatory effects. Since chronic inflammation is the major factor in the development of nasal polyposis, we have previously used mixed ultraviolet-visible light (mUV-VIS, Rhinolight®) phototherapy for the treatment of nasal polyps.

Aims

In the present open, multicenter study, our aim was to delineate whether mUV-VIS applied postoperatively in vivo together with intranasal steroid treatment could reduce the recurrence of nasal polyps.

Methods

After functional endoscopic sinus surgery, one group of patients received mUV-VIS light together with standard intranasal steroid (mometason furoate 2 × 200 μg) application for a 12-week treatment period, whereas the other patient group obtained only intranasal steroid for the same duration. We recorded nasal endoscopy images and obtained demographical and clinical data, total nasal score (TNS), and nasal obstruction symptom evaluation (NOSE). We performed acoustic rhinometry and measured nasal inspiratory peak flow. Follow-up was 12 months.

Results

We found that the recurrence of nasal polyps was significantly diminished, and based on video-endoscopic measurements, the size and grade of recurrent polyps were significantly smaller in the phototherapy-receiving group. Nasal obstruction values and NOSE were significantly better throughout the follow-up period in the mUV-VIS light-treated group than in the intranasal steroid monotreatment group.

Conclusions

Rhinophototherapy together with standard nasal steroid application may have a supportive role in the treatment of recurrent bilateral nasal polyps.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ARM:

Acoustic rhinometry

CRS:

Chronic rhinosinusitis

CRSsNP:

Chronic rhinosinusitis without nasal polyps

CRSwNP:

Chronic rhinosinusitis with nasal polyps

CT:

Computed tomography

DNA:

Deoxyribonucleic acid

ECP:

Eosinophil cationic protein

FESS:

Functional endoscopic sinus surgery

IL-5:

Interleukin-5

mUV-VIS:

Mixed ultraviolet-visible light

NB-UVB:

Narrow-band UV light

NIPF:

Nasal inspiratory peak flow

NOSE:

Nasal obstruction symptom evaluation

PND:

Post-nasal drip

TNS:

Total nasal score

References

  1. Fokkens WJ, Lund VJ, Mullol J et al (2012) European position paper on rhinosinusitis and nasal polyps. Rhinol 50(Suppl 23):1−225

  2. Hellings PW, Fokkens WJ, Bachert C et al (2017) Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis EUFOREA-ARIA-EPOS-AIRWAYS ICP statement. Allergy 72:1297–1305

    Article  CAS  Google Scholar 

  3. Pawankar R (2003) Nasal polyposis. Curr Opin Allergy Clin Immunol 3:1–6

    Article  CAS  Google Scholar 

  4. Dennis SK, Lam K, Luong A (2016) A review of classification schemes for chronic rhinosinusitis with nasal polyposis endotypes. Laryngoscope Investig Otolaryngol 1(5):130–134

    Article  Google Scholar 

  5. Bachert C, Zhang L, Gevaert P (2015) Current and future treatment options for adult chronic rhinosinusitis: focus on nasal polyposis. J Allergy Clin Immunol 136:1431–1440

    Article  CAS  Google Scholar 

  6. Tomassen P, Vandeplas G, Van Zele T et al (2016) Inflammatory endotypes of chronic rhinosinusitis based on cluster analysis of biomarkers. J Allergy Clin Immunol 137:1449–1456

    Article  CAS  Google Scholar 

  7. Lal D, Scianna JM, Stankiewicz JA (2009) Efficacy of targeted medical therapy in chronic rhinosinusitis, and predictors of failure. Am J Rhinol Allergy 23:396–400

    Article  Google Scholar 

  8. Baguley C, Brownlow A, Yeung K et al (2014) The fate of chronic rhinosinusitis sufferers after maximal medical therapy. Int Forum Allergy Rhinol 4:525–532

    Article  Google Scholar 

  9. Alobid I, Mullol J (2012) Role of medical therapy in the management of nasal polyps. Curr Allergy Asthma Rep 12:144–153

    Article  CAS  Google Scholar 

  10. Sun DI, Joo YH, Auo HJ, Kang JM (2009) Clinical significance of eosinophilic cationic protein levels in nasal secretions of patients with nasal polyposis. Eur Arch Otorhinolaryngol 266:981–986

    Article  Google Scholar 

  11. Bonis B, Kemeny L, Dobozy A et al (1997) 308 nm UVB excimer laser for psoriasis 350:1522

  12. Baltas E, Nagy P, Bonis B et al (2001) Repigmentation of localized vitiligo with the xenon chloride laser. Br J Dermatol 144:1266–1267

    Article  CAS  Google Scholar 

  13. Mitchell D, Paniker L, Sanchez G et al (2010) Molecular response of nasal mucosa to therapeutic exposure to broad-band ultraviolet radiation. J Cell Mol Med 14:313–322

    Article  CAS  Google Scholar 

  14. Zs C, Koreck AI, Ignacz F et al (2006) PUVA treatment of the nasal cavity improves the clinical symptoms of allergic rhinitis and inhibits the immediate-type hypersensitivity reaction in the skin. J Photochem Photobiol B 83:21–26

    Article  Google Scholar 

  15. Kemeny L, Koreck AI, Szechenyi A et al (2007) Effects of intranasal phototherapy on nasal mucosa in patients with allergic rhinitis. J Photochem Photobiol B 89:163–169

    Article  Google Scholar 

  16. Koreck AI, Zs C, Bodai L et al (2005) Rhinophototherapy: a new therapeutic tool for the management of allergic rhinitis. J Allergy Clin Immunol 115:541–547

    Article  Google Scholar 

  17. Bella Z, Kiricsi A, Viharosne ED et al (2017) Rhinophototherapy in persistent allergic rhinitis. Eur Arch Otorhinolaryngol 274(3):1543–1550

    Article  Google Scholar 

  18. Kemeny L, Koreck AI (2007) Ultraviolet light phototherapy for allergic rhinitis. J Photochem Photobiol B 87:58–65

    Article  CAS  Google Scholar 

  19. Zs B, Kadocsa E, Kemeny L et al (2010) Narrow-band UVB phototherapy of nasal polyps: results of a pilot study. J Photochem Photobiol B 100:123–127

    Article  Google Scholar 

  20. Kiricsi A, Tiszlavicz L, Razga Z et al (2017) Prospective, multicenter, randomized clinical study to evaluate the clinical efficacy and tolerability of long term mixed ultraviolet and visible light phototherapy in eosinophil nasal polyps. J Photochem Photobiol B 176:118–123

    Article  CAS  Google Scholar 

  21. Nemeth IB, Zsiros O, Koreck AI et al (2012) Ultraviolet light and photodynamic therapy induce apoptosis in nasal polyps. J Photochem Photobiol B 117:179–184

    Article  CAS  Google Scholar 

  22. Koreck AI, Szechenyi A, Cimpean A et al (2007) DNA damage and repair in nasal mucosa after rhinophototherapy. Allergy 62(Suppl. 83):230

    Google Scholar 

  23. Meltzer E, Hamilos D, Hadley JA et al (2006) Rhinosinusitis: developing guidance for clinical trials. J Allergy Clin Immunol 118:S17–S61

    Article  Google Scholar 

  24. Stewart MG, Witsell DL, Smith TL et al (2004) Development and validation of the Nose Obstruction Symptom Evaluation (NOSE) Scale. Otolaryngol Head Neck Surg 130:157–163

    Article  Google Scholar 

  25. Nathan RA, Eccles R, Howarth PH et al (2005) Objective monitoring of nasal patency and nasal phisiology in rhinitis. J Allergy Clin Immonol 115:442–459

    Article  Google Scholar 

  26. Spronsen E, Ingels KJ, Jansen AH et al (2008) Evidence-based recommendations regarding the differential diagnosis and assessment of nasal congestion: using the new GRADE system. Allergy 63:820–833

    Article  Google Scholar 

  27. Proimos EK, Kiaiadaki DE, Chimona TS et al (2015) Comparison of acoustic rhinometry and nasal inspiratory peak flow as objective tools for nasal obstruction assessment in patients with chronic rhinosinusitis. Rhinol 53:66–74

    Article  Google Scholar 

  28. Batra PS, Tong L, Citardi MJ (2013) Analysis of comorbidities and objective parameters in refractory chronic rhinosinusitis. Laryngoscope 123(Suppl 7):S1-11

    Article  Google Scholar 

  29. McMains KC, Kountakis SE (2005) Revision functional endoscopic sinus surgery: objective and subjective surgical outcomes. Am J Rhinol 19(4):344–347

    Article  Google Scholar 

  30. Wynn R, Har-El G (2004) Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 114(5):811–813

    Article  Google Scholar 

  31. DeConde AS, Mace JC, Levy JM et al (2017) Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope 127(3):550–555

    Article  Google Scholar 

  32. Veloso-Teles R, Cerejeira R (2017) Endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps: clinical outcome and predictive factors of recurrence. Am J Rhinol Allergy 31(1):56–62

    Article  Google Scholar 

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Funding

This work was funded by the Jedlik Ányos Program NKP-07-A1-ORLPOLYP-hu (OM-00033-36/2008).

Author information

Author notes

  1. Ágnes Kiricsi and Mónika Kiricsi contributed equally to the work.

Authors and Affiliations

  1. Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University of Szeged, Tisza L. Krt 111, 6720, Szeged, Hungary

    Ágnes Kiricsi, Edit Kadocsa, László Rovó & Zsolt Bella

  2. Department of Biochemistry and Molecular Biology, University of Szeged, Középfasor 52, 6726, Szeged, Hungary

    Mónika Kiricsi

  3. Department of ENT and Operative Dentistry, Hospital of B.A.Z. County, Szentpéteri kapu 72-76, 3526, Miskolc, Hungary

    Zsolt Szabó

  4. Department of Dermatology and Allergology, University of Szeged, Korányi fasor 6, 6720, Szeged, Hungary

    Éva Dósa-Rácz Viharosné & Lajos Kemény

  5. Department of Optics and Quantum Electronics, University of Szeged, Dóm tér 9, 6720, Szeged, Hungary

    Ferenc Ignácz

Authors
  1. Ágnes Kiricsi
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  2. Mónika Kiricsi
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  7. Edit Kadocsa
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  8. László Rovó
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Contributions

ÁK, MK, and BZS interpreted the results and drafted the manuscript, ÁK, BZS, ZSSZ, and EK performed the visits and acquired the data; LK and EK conceived the work. ÉDR and MK performed statistical analysis. FI developed instruments used in the study. LK, EK, and LR coordinated the related research activities and supervised all experiments. All authors revised and approved the final version of the manuscript.

Corresponding author

Correspondence to Ágnes Kiricsi.

Ethics declarations

Ethics approval and consent to participate

The study was approved by The Ethics Committee of the University of Szeged, Hungary. All patients gave informed consents. The scheme of the experiments complies with the ethics of research and agrees with the declaration of the Medical World Federation proclaimed in Helsinki in 1964. Human Investigation Board of the University of Szeged #159/2010.

Consent for publication

All the authors have read the manuscript and approved its submission.

Competing interests

The authors declare that they have no competing interests.

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Kiricsi, Á., Kiricsi, M., Szabó, Z. et al. Open, prospective, multicenter study on postoperative intranasal phototherapy in nasal polyposis. Ir J Med Sci 191, 375–383 (2022). https://doi.org/10.1007/s11845-021-02518-1

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  • DOI: https://doi.org/10.1007/s11845-021-02518-1

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