Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jul 1:8:2050312120936731.
doi: 10.1177/2050312120936731. eCollection 2020.

The role of surgery in antineutrophil cytoplasmic antibody-associated vasculitides affecting the nose and sinuses: A systematic review

Alfonso Luca Pendolino  1   2 , Samit Unadkat  1 , Henry Zhang  1 , Monica Pendolino  3 , Gerolamo Bianchi  3 , Premjit S Randhawa  1 , Peter J Andrews  1   2
Affiliations
Review

The role of surgery in antineutrophil cytoplasmic antibody-associated vasculitides affecting the nose and sinuses: A systematic review

Alfonso Luca Pendolino et al. SAGE Open Med. .

Abstract

Background: The ear, nose and throat region has been reported to be one of the commonest sites involved in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis diseases and often precedes the diagnosis of ANCA-associated vasculitis by many months. Although treatment for ANCA-associated vasculitis primarily requires systemic immunosuppressive therapy, there are specific indications for sinonasal surgery during the course of the disease process. The three major roles for surgery in sinonasal vasculitis are to aid diagnosis through biopsy, enable symptom relief and nasal reconstructive surgery consideration when in remission.

Purpose: The aim of this systematic review is to provide an overview of the surgical procedures which can be performed in patients with ANCA-associated vasculitis presenting with sinonasal involvement.

Materials and methods: A systematic literature search was performed for scientific articles on MEDLINE (PubMed Advanced MEDLINE Search) and EMBASE. The search included all articles up to April 2020.

Conclusion: Surgical intervention during the active phase of ANCA-associated vasculitis disease can improve the patient's symptoms and enable histological diagnosis. The surgical decision to manage the nose requires a multidisciplinary approach involving the vasculitis specialist and the ear, nose and throat surgeon. Nasal reconstruction can be performed to restore form and function but only when the disease is in remission so as to maximise success and minimise complications.

Keywords: ANCA-associated vasculitis diseases; antineutrophil cytoplasmic antibody; dacryocystorhinostomy; endoscopic sinus surgery; eosinophilic granulomatosis with polyangiitis; granulomatosis with polyangiitis; microscopic polyangiitis; saddle nose deformity; septal perforation.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Systematic review flowchart.
Figure 2.
Figure 2.
Number and percentage (No.; %) of papers cited related to surgical procedures in relation to study design and AAV disease.
See this image and copyright information in PMC

References

    1. Leavitt RY, Fauci AS, Bloch DA, et al. The American college of rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum 1990; 33(8): 1101–1107. - PubMed
    1. Masi AT, Hunder GG, Lie JT, et al. The American college of rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 1990; 33(8): 1094–1100. - PubMed
    1. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised international Chapel Hill consensus conference nomenclature of vasculitides. Arthritis Rheum 2013; 65(1): 1–11. - PubMed
    1. Wojciechowska J, KręCicki T. Clinical characteristics of patients with granulomatosis with polyangiitis and microscopic polyangiitis in ENT practice: a comparative analysis. Acta Otorhinolaryngol Ital 2018; 38(6): 517–527. - PMC - PubMed
    1. Alam DS, Seth R, Sindwani R, et al. Upper airway manifestations of granulomatosis with polyangiitis. Cleve Clin J Med 2012; 79(Suppl. 3): S16–21. - PubMed

LinkOut - more resources