A Preliminary Study On The Relationship Between Laryngopharyngeal Reflux And Chronic Rhinosinusitis

Objective:We examined the expression of pepsin by immunohistochemical method in there groups which were chronic nasosinusitis with nasal polyps,chronic sinusitis without nasal polyps and control groups.To explore the role of laryngopharyngeal reflux in the pathogenesis of chronic rhinosinusitis,hoping to provide new ideas and new methods for the diagnosis and treatment of chronic rhinosinusitis.Methods:there were 46 patients undergoing surgical treatment at the Department of Otolaryngology in Affiliated Hospital of Chengde Medical College from march 2017 to august 2017,Nasal polyps group included 25 patients who were preoperative diagnosed as chronic rhinosinusitis with nasal polyps,and their surgical resection of the pathological were also be diagnosed as nasal polyps.chronic rhinosinusitis without nasal polyps group included 11 patients who were preoperative diagnosed as chronic rhinosinusitis,control group included 10 patients who undergoing surgical treatment just because abnormal nasal anatomy(such as nasal septum deviation,bubble in the turbinate,etc.).Immunohistochemical method was used to detect the expression level of pepsin in the three groups,and the intensity of pepsin expression in the three groups were compared.The intensity of pepsin expression and the Peripheral blood eosinophils percentage,neutrophils percentage,basohils percentage,mononuclear percentage,lymphocytes percentage were also analyzed.P<0.05 was considered a significant difference.Results:There were 8 strong positive cases(32%,8/25),8 positive cases(32%,8/25),2 weakly positive cases(8%,2/25),7 negative cases(28%,7/25)in the chronic rhinosinusitis with nasal polyps.In the chronic rhinosinusitis without nasal polyps group,the expression of pepsin was strong positive in 4 cases(40%,4/10),positive in 3 cases(30%,3/10),weakly positive in 1 case(10%,1/10),Negative in 2 cases(20%,2/10).There were 0 strong positive case(0%,0/10),2 positive cases(18.2%,2/11),3 weakly positive cases(27.3%,3/11),6 negative cases(54.5%,6/11)in the control group,the intensity of pepsin expression the chronic rhinosinusitis with nasal polyps group and the chronic rhinosinusitis without nasal polyps group was higher than the control group(P<0.05),the intensity of pepsin expression in chronic rhinosinusitis with nasal polyps group and chronic rhinosinusitis without nasal polyps group was no significant difference(P > 0.05).Spearman correlation analysis indicated that the intensity of pepsin expression was no correlation with the pacentage of various inflammatory cells of peripheral blood.Conclusion:The positive intensity of pepsin expression in the chronic rhinosinusitis without nasal polyps and the chronic rhinosinusitis with nasal polyps is significantly higher than that in normal control group,suggesting that there is a correlation between chronic rhinosinusitis and laryngopharyngeal reflux,which may be chronic rhinosinusitis risk factor.Chronic rhinosinusitis inflammation caused by laryngopharyngeal reflux is not a certain kind of inflammatory cells.