Chronic Rhinosinusitis with Nasal Polyps in Older Adults: Clinical Presentation, Pathophysiology, and Comorbidity.

Publisher: Current Science Inc Country of Publication: United States NLM ID: 101096440 Publication Model: Electronic Cited Medium: Internet ISSN: 1534-6315 (Electronic) Linking ISSN: 15297322 NLM ISO Abbreviation: Curr Allergy Asthma Rep Subsets: MEDLINE

Original Publication: Philadelphia, PA : Current Science Inc., c2001-

Nasal Polyps/*etiology ; Rhinitis/*epidemiology ; Sinusitis/*epidemiology; Aged ; Chronic Disease ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps/physiopathology ; Rhinitis/physiopathology ; Sinusitis/physiopathology

Purpose of Review: Chronic rhinosinusitis and nasal polyps (CRSwNP) is a common condition that significantly affects patients' life. This work aims to provide an up-to-date overview of CRSwNP in older adults, focusing on its aging-related clinical presentations, pathophysiology, and comorbidity associations including asthma.
Recent Findings: Recent large population-based studies using nasal endoscopy have shown that CRSwNP is a mostly late-onset disease. Age-related changes in physiologic functions, including nasal epithelial barrier dysfunction, may underlie the incidence and different clinical presentations of CRSwNP in older adults. However, there is still a paucity of evidence on the effect of aging on phenotypes and endotypes of CRSwNP. Meanwhile, late-onset asthma is a major comorbid condition in patients with CRSwNP; they frequently present with type 2 inflammatory signatures that are refractory to conventional treatments when they are comorbid. However, as they are more commonly non-atopic, causative factors other than classical atopic sensitization, such as Staphylococcus aureus specific IgE sensitization, are suggested to drive the type 2 inflammation. There are additional comorbidity associations in older patients with CRSwNP, including those with chronic otitis media and head and neck malignancy. Age is a major determinant for the incidence and clinical presentations of CRSwNP. Given the heterogeneity in phenotypes and endotypes, longitudinal investigations are warranted to elucidate the effects of aging on CRSwNP.

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Keywords: Aging; Asthma; Chronic rhinosinusitis; Comorbidity; Nasal polyps

Date Created: 20190906 Date Completed: 20200505 Latest Revision: 20200505

20221213

10.1007/s11882-019-0880-4

31486905