만성 비부비동염의 표현형에 따른 올바른 약물 치료
Medical treatment according to phenotypes of chronic rhinosinusitis
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초록
Chronic rhinosinusitis is generally divided into 2 types. One is chronic rhinosinusitis with nasal polyps and the other is chronic rhinosinusitis without nasal polyps. However, this classification has the drawbacks no consideration of various immunologic characters of chronic rhinosinusitis and too simple grouping. To compensate for these drawbacks, 1 recent classification has utilized histologic and immunologic parameters to subdivide chronic rhinosinusitis with nasal polyps into that with eosinophilic polyps and that with noneosinophilic nasal polyps. Moreover, phenotyping of chronic rhinosinusitis by using various clinical parameters such as biopsy, computed tomography, and endoscopic findings is very important for the appropriate medical treatment. In this review, before discussing the overall medical treatment of chronic rhinosinusitis, we describe not only clinical characters of chronic rhinosinusitis without nasal polyps but also the immunologic and histologic differentiation of chronic rhinosinusitis cases with eosinophilic and noneosinophilic nasal polyps closely related to the phenotype of chronic rhinosinusitis.
Abstract
Chronic rhinosinusitis is generally divided into 2 types. One is chronic rhinosinusitis with nasal polyps and the other is chronic rhinosinusitis without nasal polyps. However, this classification has the drawbacks no consideration of various immunologic characters of chronic rhinosinusitis and too simple grouping. To compensate for these drawbacks, 1 recent classification has utilized histologic and immunologic parameters to subdivide chronic rhinosinusitis with nasal polyps into that with eosinophilic polyps and that with noneosinophilic nasal polyps. Moreover, phenotyping of chronic rhinosinusitis by using various clinical parameters such as biopsy, computed tomography, and endoscopic findings is very important for the appropriate medical treatment. In this review, before discussing the overall medical treatment of chronic rhinosinusitis, we describe not only clinical characters of chronic rhinosinusitis without nasal polyps but also the immunologic and histologic differentiation of chronic rhinosinusitis cases with eosinophilic and noneosinophilic nasal polyps closely related to the phenotype of chronic rhinosinusitis.
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