Effect of Full-House ESS With Nasopharyngeal Lymphoid Tissue Ablation on Nasal Polyps
Effect of Full-House Endoscopic Sinus Surgery With Versus Without Nasopharyngeal Lymphoid Ablation on Local Mucosal Inflammation in Chronic Rhinosinusitis With Nasal Polyps
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Yin Yao
- Phone Number: 86 15071077020
- Email: Dr.yaoyin@hotmail.com
Study Contact Backup
- Name: Xing-Liang Wu
- Phone Number: 86 15131662389
- Email: 15131662389@163.com
Study Locations
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Hubei
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Wuhan, Hubei, China, 430030
- Recruiting
- Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology
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Contact:
- Yin Yao
- Phone Number: 86 15071077020
- Email: Dr.yaoyin@hotmail.com
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged 18-65 years
- Diagnosed with CRSwNP according to EPOS criteria
- Blood eosinophil count > 0.3 × 10⁹/L
Exclusion Criteria:
- Pregnant or lactating women.
- Cystic fibrosis
- primary ciliary dyskinesia
- fungal ball rhinosinusitis
- systemic vasculitis or granulomatous disease
- malignancy
- immunodeficiency.
- Subjects with an upper-respiratory-tract infection within the past 4 weeks.
- Clinically significant metabolic, cardiovascular, immune, neurologic, hematologic, gastrointestinal, cerebrovascular, or respiratory disorders, or any condition that, in the investigator's opinion, could interfere with outcome assessment or compromise patient safety.
- Currently participating in another clinical trial or having participated in one within 30 days, or staff directly involved in this study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Full-House Endoscopic Sinus Surgery Combined with Nasopharyngeal Lymphoid Tissue Ablation
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The nasal mucosa is initially decongested using a topical vasoconstrictor.
A small-caliber urethral catheter is then introduced through each nasal cavity to elevate the soft palate.
A 45° rigid nasoendoscope is inserted transorally to visualize the nasopharynx.
Under endoscopic guidance, the nasopharyngeal lymphoid tissue is identified on the nasopharyngeal roof.
Following aspiration of any secretions, the tissue is completely resected with a plasma scalpel.
After complete removal of the nasal polyps, a full ethmoidectomy is performed, removing all bony septa within the sinuses.
Conventional sphenoidotomy and frontal sinusotomy are carried out, with or without preservation of the middle turbinate.
Only irreversibly polypoid mucosa is resected, while normal mucosa is preserved.
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Active Comparator: Full-House Endoscopic Sinus Surgery
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After complete removal of the nasal polyps, a full ethmoidectomy is performed, removing all bony septa within the sinuses.
Conventional sphenoidotomy and frontal sinusotomy are carried out, with or without preservation of the middle turbinate.
Only irreversibly polypoid mucosa is resected, while normal mucosa is preserved.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Numbers and Proportions of Nasal Mucosa inflammatory cells in Patients With Nasal Polyps at Baseline and 1, 3, and 6 Months After Surgery
Time Frame: At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Sampling of the ethmoid sinus mucosa from patients after surgery is performed under nasal endoscopic guidance; nasopharyngeal swabs are used to collect samples from the nasopharynx.
The method for nasopharyngeal sampling is as follows: The subject sits in a seated position, blows their nose, and closes their eyes before swab sample collection to facilitate relaxation and ease of sampling.
A professional doctor gently inserts the nasal swab into one nostril along the bottom of the nasal cavity (parallel to the hard palate) until it reaches the nasopharynx, then rotates the swab approximately five times in the nasopharynx.
The swab is placed into a collection tube containing 2 mL of RPMI medium.
One nasopharyngeal swab is collected per donor each time.
After processing, flow cytometry is used for analysing the numbers and proportions of inflammatory cells (including T cells, B cells, Plasma cells, Eosinophils, and Neutrophils).
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At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Inflammatory Cytokine Levels in Nasal Secretions Post - surgery
Time Frame: At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Detection of inflammatory cytokine levels (e.g., IL - 5, IL - 13) in nasal secretions.
Samples are collected via nasal swab, then processed and analyzed using immunoassay techniques (e.g., ELISA).
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At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Total VAS Score and Symptom - specific VAS Scores Post - surgery
Time Frame: At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Evaluate total VAS score and individual symptoms (nasal obstruction, mucopurulent discharge, postnasal drip, headache/dizziness, facial fullness, hyposmia/anosmia, sneezing, sleep disturbance, fatigue, general discomfort).
Scores are self - reported by patients using a 0 - 10 scale.
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At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Nasal Endoscopy Scores
Time Frame: At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Assess nasal endoscopy scores.
The scoring includes signs such as nasal polyps, mucosal edema, secretions, crusting, and scarring.
Trained clinicians perform nasal endoscopy at each time point following a standardized protocol and record scores based on the presence and severity of these signs.
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At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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SNOT - 22 Score Changes Post - surgery
Time Frame: At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Assess quality - of - life symptoms (nasal discharge, sneezing, rhinorrhea, cough, postnasal drip, purulent discharge, smell/taste disturbance, nasal obstruction/congestion, ear fullness, dizziness, ear pain, facial pain/pressure, difficulty falling asleep, nighttime awakenings, poor sleep quality, morning fatigue, daytime fatigue, decreased work efficiency, difficulty concentrating, depression/irritability, anxiety, restlessness) via the SNOT - 22 questionnaire.
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At baseline (before surgery) and 1 month, 3 months, and 6 months after surgery.
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Polyp Recurrence Post-surgery
Time Frame: Focus on the first 6 months post-surgery, with extended monitoring continuing up to 24 months.
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Polyp recurrence assessed by nasal endoscopy.
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Focus on the first 6 months post-surgery, with extended monitoring continuing up to 24 months.
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Rate of Reoperation
Time Frame: Focused on 6 months post-surgery; continued monitoring to 24 months post-surgery.
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Assess the proportion of patients undergoing reoperation within 6 months after surgery. Reoperation is indicated if:
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Focused on 6 months post-surgery; continued monitoring to 24 months post-surgery.
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Postoperative Rescue Treatment Medication Use
Time Frame: Within 6 months post-surgery.
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Record rescue treatment (oral methylprednisolone: days 1-5: 30 mg, days 6-10: 20 mg, days 11-15: 10 mg, days 16-20: 5 mg) initiation for symptom/polyp recurrence.
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Within 6 months post-surgery.
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Postoperative Complications
Time Frame: Within 6 months after surgery.
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Record postoperative complications, including bleeding, infection, and altered Sense of Smell.
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Within 6 months after surgery.
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Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- TJ-IRB202506055
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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