Author(s)
Rachel Akers, MS
Grant Primer, Medical Student
Thomas Cyberski, Resident Physician
Ali Baird, Dr.
Pete Batra, MD, FARS
Peter Filip, MD
Peter Papagiannopoulos, MD
Bobby Tajudeen, MD, FARS
Affiliation(s)
Rush University Medical Center;
Abstract:
Background:
Chronic rhinosinusitis (CRS) is a condition that impacts millions. Mucosal irritants, like allergens and bacteria, contribute to disease pathogenesis and produce distinct histopathological features. However, the literature on the impact of illicit drug use on CRS histopathology remains limited. This retrospective study identified CRS patients with history of drug use to further understand unique histopathological features.
Methods:
Patients with diagnosis of CRS and documented substance use who underwent endoscopic sinus surgery were included in the study. Demographics, type of substances used, and structured histopathology reports were collected. Data was compared to CRS control groups through Chi-square testing.
Results:
13 patients with a history of substance use were identified. Heroin, methamphetamine, cannabis and phencyclidine users were present; some used more than one drug. Most patients were White (69.2%) and male (76.9%). Subepithelial edema (53.8% vs 26.6%, p=0.03) and basement membrane thickening (69.2% vs 30.8%, p=0.006) were both significantly more common amongst the drug user group when compared with non-users. Drug users also had higher prevalence of fibrosis (38.5% vs 17.6%, p=0.06). No significant differences were found between other histopathological features.
Conclusion:
CRS patients with history of substance use had a higher prevalence of subepithelial edema, basement membrane thickening and fibrosis than those with CRS without a history of substance use. These findings suggest a higher level of acute and chronic sinonasal inflammation amongst drug-using patients. Future studies in this population are necessary to establish how these differences may impact management of CRS.