gms | German Medical Science

The amount of cytokine production in nasal polyposis not only correlates with the preoperative situation and the inflammatory status, but also with the postoperative results. To further analyze this relation, we prospectively investigated the production of Th1- and Th2-cytokines in the nasal mucosa after endoscopic sinus surgery for 6 months in 25 patients with bilateral nasal polyposis. To this end, we performed nasal scrapings in the middle nasal meatus preoperatively, 1, 2, 3, and 6 months postoperatively. The production of the cytokines IL-4 and IFN-γ in the collected cells were measured using ELISPOT-assays. At the same time clinical data (symptomscores and polyp scores (Lildholdt 1997)) were documented. For statistical analyses, non-parametric tests (One-way ANOVA with Bonferroni-correction) were employed. Symptomscores and polyp scores were significantly improved (p<0.001) from the first to the sixth month after surgery. The production of the cytokines IL-4 and IFN-γ was detectable at all timepoints and in all specimen. In contrast to the clinical parameters, there were no significant changes (p>0.5) in the number of cytokine-producing cells in the mucosa at any timepoints. These results emphasize the relevance of the chronic inflammatory nature of nasal polyposis since the increased production of cytokines persists despite improvements of symptoms and endoscopic findings. This points to the paramount importance of anti-inflammatory treatment even after clinically successful surgery of nasal polyposis.