Skip to main content
Erschienen in: Irish Journal of Medical Science (1971 -) 1/2022

05.02.2021 | Original Article

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

verfasst von: Ágnes Kiricsi, Mónika Kiricsi, Zsolt Szabó, Éva Dósa-Rácz Viharosné, Ferenc Ignácz, Lajos Kemény, Edit Kadocsa, László Rovó, Zsolt Bella

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 1/2022

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Fokkens WJ, Lund VJ, Mullol J et al (2012) European position paper on rhinosinusitis and nasal polyps. Rhinol 50(Suppl 23):1−225 Fokkens WJ, Lund VJ, Mullol J et al (2012) European position paper on rhinosinusitis and nasal polyps. Rhinol 50(Suppl 23):1−225
2.
Zurück zum Zitat 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 72:1297–1305CrossRef 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 72:1297–1305CrossRef
3.
Zurück zum Zitat Pawankar R (2003) Nasal polyposis. Curr Opin Allergy Clin Immunol 3:1–6CrossRef Pawankar R (2003) Nasal polyposis. Curr Opin Allergy Clin Immunol 3:1–6CrossRef
4.
Zurück zum Zitat Dennis SK, Lam K, Luong A (2016) A review of classification schemes for chronic rhinosinusitis with nasal polyposis endotypes. Laryngoscope Investig Otolaryngol 1(5):130–134CrossRef Dennis SK, Lam K, Luong A (2016) A review of classification schemes for chronic rhinosinusitis with nasal polyposis endotypes. Laryngoscope Investig Otolaryngol 1(5):130–134CrossRef
5.
Zurück zum Zitat Bachert C, Zhang L, Gevaert P (2015) Current and future treatment options for adult chronic rhinosinusitis: focus on nasal polyposis. J Allergy Clin Immunol 136:1431–1440CrossRef Bachert C, Zhang L, Gevaert P (2015) Current and future treatment options for adult chronic rhinosinusitis: focus on nasal polyposis. J Allergy Clin Immunol 136:1431–1440CrossRef
6.
Zurück zum Zitat 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 137:1449–1456CrossRef 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 137:1449–1456CrossRef
7.
Zurück zum Zitat Lal D, Scianna JM, Stankiewicz JA (2009) Efficacy of targeted medical therapy in chronic rhinosinusitis, and predictors of failure. Am J Rhinol Allergy 23:396–400CrossRef Lal D, Scianna JM, Stankiewicz JA (2009) Efficacy of targeted medical therapy in chronic rhinosinusitis, and predictors of failure. Am J Rhinol Allergy 23:396–400CrossRef
8.
Zurück zum Zitat Baguley C, Brownlow A, Yeung K et al (2014) The fate of chronic rhinosinusitis sufferers after maximal medical therapy. Int Forum Allergy Rhinol 4:525–532CrossRef Baguley C, Brownlow A, Yeung K et al (2014) The fate of chronic rhinosinusitis sufferers after maximal medical therapy. Int Forum Allergy Rhinol 4:525–532CrossRef
9.
Zurück zum Zitat Alobid I, Mullol J (2012) Role of medical therapy in the management of nasal polyps. Curr Allergy Asthma Rep 12:144–153CrossRef Alobid I, Mullol J (2012) Role of medical therapy in the management of nasal polyps. Curr Allergy Asthma Rep 12:144–153CrossRef
10.
Zurück zum Zitat 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 266:981–986CrossRef 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 266:981–986CrossRef
11.
Zurück zum Zitat Bonis B, Kemeny L, Dobozy A et al (1997) 308 nm UVB excimer laser for psoriasis 350:1522 Bonis B, Kemeny L, Dobozy A et al (1997) 308 nm UVB excimer laser for psoriasis 350:1522
12.
Zurück zum Zitat Baltas E, Nagy P, Bonis B et al (2001) Repigmentation of localized vitiligo with the xenon chloride laser. Br J Dermatol 144:1266–1267CrossRef Baltas E, Nagy P, Bonis B et al (2001) Repigmentation of localized vitiligo with the xenon chloride laser. Br J Dermatol 144:1266–1267CrossRef
13.
Zurück zum Zitat 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 14:313–322CrossRef 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 14:313–322CrossRef
14.
Zurück zum Zitat 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 83:21–26CrossRef 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 83:21–26CrossRef
15.
Zurück zum Zitat 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 89:163–169CrossRef 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 89:163–169CrossRef
16.
Zurück zum Zitat Koreck AI, Zs C, Bodai L et al (2005) Rhinophototherapy: a new therapeutic tool for the management of allergic rhinitis. J Allergy Clin Immunol 115:541–547CrossRef Koreck AI, Zs C, Bodai L et al (2005) Rhinophototherapy: a new therapeutic tool for the management of allergic rhinitis. J Allergy Clin Immunol 115:541–547CrossRef
17.
Zurück zum Zitat Bella Z, Kiricsi A, Viharosne ED et al (2017) Rhinophototherapy in persistent allergic rhinitis. Eur Arch Otorhinolaryngol 274(3):1543–1550CrossRef Bella Z, Kiricsi A, Viharosne ED et al (2017) Rhinophototherapy in persistent allergic rhinitis. Eur Arch Otorhinolaryngol 274(3):1543–1550CrossRef
18.
Zurück zum Zitat Kemeny L, Koreck AI (2007) Ultraviolet light phototherapy for allergic rhinitis. J Photochem Photobiol B 87:58–65CrossRef Kemeny L, Koreck AI (2007) Ultraviolet light phototherapy for allergic rhinitis. J Photochem Photobiol B 87:58–65CrossRef
19.
Zurück zum Zitat 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 100:123–127CrossRef 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 100:123–127CrossRef
20.
Zurück zum Zitat 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 176:118–123CrossRef 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 176:118–123CrossRef
21.
Zurück zum Zitat Nemeth IB, Zsiros O, Koreck AI et al (2012) Ultraviolet light and photodynamic therapy induce apoptosis in nasal polyps. J Photochem Photobiol B 117:179–184CrossRef Nemeth IB, Zsiros O, Koreck AI et al (2012) Ultraviolet light and photodynamic therapy induce apoptosis in nasal polyps. J Photochem Photobiol B 117:179–184CrossRef
22.
Zurück zum Zitat Koreck AI, Szechenyi A, Cimpean A et al (2007) DNA damage and repair in nasal mucosa after rhinophototherapy. Allergy 62(Suppl. 83):230 Koreck AI, Szechenyi A, Cimpean A et al (2007) DNA damage and repair in nasal mucosa after rhinophototherapy. Allergy 62(Suppl. 83):230
23.
Zurück zum Zitat Meltzer E, Hamilos D, Hadley JA et al (2006) Rhinosinusitis: developing guidance for clinical trials. J Allergy Clin Immunol 118:S17–S61CrossRef Meltzer E, Hamilos D, Hadley JA et al (2006) Rhinosinusitis: developing guidance for clinical trials. J Allergy Clin Immunol 118:S17–S61CrossRef
24.
Zurück zum Zitat Stewart MG, Witsell DL, Smith TL et al (2004) Development and validation of the Nose Obstruction Symptom Evaluation (NOSE) Scale. Otolaryngol Head Neck Surg 130:157–163CrossRef Stewart MG, Witsell DL, Smith TL et al (2004) Development and validation of the Nose Obstruction Symptom Evaluation (NOSE) Scale. Otolaryngol Head Neck Surg 130:157–163CrossRef
25.
Zurück zum Zitat Nathan RA, Eccles R, Howarth PH et al (2005) Objective monitoring of nasal patency and nasal phisiology in rhinitis. J Allergy Clin Immonol 115:442–459CrossRef Nathan RA, Eccles R, Howarth PH et al (2005) Objective monitoring of nasal patency and nasal phisiology in rhinitis. J Allergy Clin Immonol 115:442–459CrossRef
26.
Zurück zum Zitat 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 63:820–833CrossRef 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 63:820–833CrossRef
27.
Zurück zum Zitat 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 53:66–74CrossRef 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 53:66–74CrossRef
28.
Zurück zum Zitat Batra PS, Tong L, Citardi MJ (2013) Analysis of comorbidities and objective parameters in refractory chronic rhinosinusitis. Laryngoscope 123(Suppl 7):S1-11CrossRef Batra PS, Tong L, Citardi MJ (2013) Analysis of comorbidities and objective parameters in refractory chronic rhinosinusitis. Laryngoscope 123(Suppl 7):S1-11CrossRef
29.
Zurück zum Zitat McMains KC, Kountakis SE (2005) Revision functional endoscopic sinus surgery: objective and subjective surgical outcomes. Am J Rhinol 19(4):344–347CrossRef McMains KC, Kountakis SE (2005) Revision functional endoscopic sinus surgery: objective and subjective surgical outcomes. Am J Rhinol 19(4):344–347CrossRef
30.
Zurück zum Zitat Wynn R, Har-El G (2004) Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 114(5):811–813CrossRef Wynn R, Har-El G (2004) Recurrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 114(5):811–813CrossRef
31.
Zurück zum Zitat 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):550–555CrossRef 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):550–555CrossRef
32.
Zurück zum Zitat 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):56–62CrossRef 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):56–62CrossRef
Metadaten
Titel
Open, prospective, multicenter study on postoperative intranasal phototherapy in nasal polyposis
verfasst von
Ágnes Kiricsi
Mónika Kiricsi
Zsolt Szabó
Éva Dósa-Rácz Viharosné
Ferenc Ignácz
Lajos Kemény
Edit Kadocsa
László Rovó
Zsolt Bella
Publikationsdatum
05.02.2021
Verlag
Springer International Publishing
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 1/2022
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-021-02518-1

Weitere Artikel der Ausgabe 1/2022

Irish Journal of Medical Science (1971 -) 1/2022 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Bei seelischem Stress sind Checkpoint-Hemmer weniger wirksam

03.06.2024 NSCLC Nachrichten

Wie stark Menschen mit fortgeschrittenem NSCLC von einer Therapie mit Immun-Checkpoint-Hemmern profitieren, hängt offenbar auch davon ab, wie sehr die Diagnose ihre psychische Verfassung erschüttert

Antikörper mobilisiert Neutrophile gegen Krebs

03.06.2024 Onkologische Immuntherapie Nachrichten

Ein bispezifischer Antikörper formiert gezielt eine Armee neutrophiler Granulozyten gegen Krebszellen. An den Antikörper gekoppeltes TNF-alpha soll die Zellen zudem tief in solide Tumoren hineinführen.

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.