[Immunodeficiency in chronic rhinosinusitis : An important and often underestimated cause]

HNO. 2019 Sep;67(9):715-730. doi: 10.1007/s00106-019-0719-2.
[Article in German]

Abstract

Background: Chronic rhinosinusitis (CRS) is one of the most frequent chronic diseases. Among these patients the prevalence of immune defects is higher than in the healthy general population.

Methods: A selective review of the literature was carried out in PubMed and Medline covering the period between 2008 and 2019. Additionally, recent German publications in journals not listed in the abovementioned databases were analyzed.

Results: The diagnostic workflow with respect to the immunodeficiency consists of a detailed anamnesis and physical examination, laboratory tests and the antibody reaction to polysaccharide vaccines and antigens. Beside antibiotic treatment, vaccinations and immunoglobulin replacement are available. Notwithstanding the above, functional endoscopic surgery of the paranasal sinuses should be performed according to guideline recommendations.

Conclusion: Patients with CRS who do not sufficiently respond to conservative and surgical treatment should be checked for underlying immunodeficiencies.

Keywords: Common variable immunodeficiency; Immunoglobulins; Nasal mucosa; Paranasal sinuses; Specific antibody deficiency.

MeSH terms

  • Chronic Disease
  • Endoscopy
  • Humans
  • Immune System Diseases* / complications
  • Paranasal Sinuses*
  • Rhinitis* / complications
  • Rhinitis* / immunology
  • Sinusitis* / complications
  • Sinusitis* / immunology