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Clinical course of rhinosinusitis and efficacy of sinonasal evaluation in kidney transplant recipients: review of 1589 patients

European Archives of Oto-Rhino-Laryngology volume 275, pages 1183–1188 (2018)Cite this article

Abstract

Introduction

Rhinosinusitis in patients who undergo kidney transplantation (KT) might have specific clinical characteristics due to immune status of recipients. The aim of this study was to identify the clinical course of rhinosinusitis after KT and to evaluate the efficacy of routine sinonasal evaluation before KT.

Methods

The study included 1589 kidney transplant adult patients who underwent preoperative sinonasal evaluation including sinonasal symptoms, nasal endoscopy, and plain X-ray between November 1994 and December 2013 (19 years). Demographic data and clinical course of rhinosinusitis were evaluated retrospectively.

Results

The study population consisted of 897 men (56.5%) and 692 women (43.5%) with a mean age of 42.5 years (range 18–75 years). The prevalence of pre-KT rhinosinusitis was 4.2% (66/1589), and that of post-KT rhinosinusitis was 0.9% (13/1503). The prevalence of acute rhinosinusitis and chronic rhinosinusitis (CRS) was 0.13 and 2.33% in pre-KT patients and 0.2 and 0.6% in post-KT patients, respectively. The recurrence rate of CRS in pre-KT patients was 37.8%. Of the 27 asymptomatic patients, the recurrence rate was 11.1%. Symptomatic patients had more severe endoscopic findings and higher Lund-Mackay CT scores than asymptomatic patients. The prevalence of fungal ball (0.8% in pre-KT and 0.3% in post-KT patients) was similar to that in the general population, and only one patient experienced invasive fungal rhinosinusitis after KT. No patient with pre-KT rhinosinusitis experienced severe complications.

Conclusions

The prevalence and recurrence rate of rhinosinusitis in KT patients was not increased after KT. Symptomatic patients needed surgical or medical treatment before KT, but asymptomatic patients showed no deterioration of clinical course after KT. Routine sinonasal evaluation for asymptomatic patients is not recommended before KT.

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  1. Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea

    Gwanghui Ryu, Min Young Seo, Kyung Eun Lee, Hyo Yeol Kim, Hun-Jong Dhong, Seung-Kyu Chung & Sang Duk Hong

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  1. Gwanghui Ryu
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  2. Min Young Seo
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Correspondence to Sang Duk Hong.

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The authors have declared that no competing interests exist.

Ethics approval

The Institutional Review Board of Samsung Medical Center approved this study, and the need for informed consent was waived (IRB No. 2015-07-056).

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Ryu, G., Seo, M.Y., Lee, K.E. et al. Clinical course of rhinosinusitis and efficacy of sinonasal evaluation in kidney transplant recipients: review of 1589 patients. Eur Arch Otorhinolaryngol 275, 1183–1188 (2018). https://doi.org/10.1007/s00405-018-4941-4

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  • DOI: https://doi.org/10.1007/s00405-018-4941-4

Keywords

  • Kidney transplantation
  • End-stage renal disease
  • Rhinosinusitis
  • Sinonasal evaluation