耳鼻科ジャーナル

The Role of Atopy and Asthma Status in Chronic Rhinosinusitis in Adults

Mahdi A. Shkoukani and John H. Krouse

The Role of Atopy and Asthma Status in Chronic Rhinosinusitis in Adults

Background: Chronic rhinosinusitis (CRS) is a prevalent chronic disease. Allergy and asthma in CRS patients have been discussed extensively in the literature. Epidemiologic studies support the connection between allergy and CRS although a direct causal link has not been established. The aim of this study was to assess the role of atopy and asthma status in predicting both the outcome of surgically treated chronic rhinosinusitis (CRS) and the severity of disease as assessed by radiologic findings.

Methods: Medical records of adults with CRS who failed medical therapy and underwent functional endoscopic sinus surgery (FESS) in 5 consecutive years were reviewed. All patients were included who had complete documentation for specific inclusion criteria: gender, age, asthma status, allergy status, surgical revision rate, Lund-Mackay score, presence/absence of polyposis, and disease recurrence within the first year following FESS.

Results: Fifty-three patients met the inclusion criteria. Positive inhalant allergy skin tests were noted in 79% of patients. Both atopic patients and asthmatic patients had statistically significantly higher Lund-Mackay scores than their non-atopic/non-asthmatic counterparts. There were no significant differences between atopic/asthmatic and non-atopic/non-asthmatic patients in one-year surgical outcome and surgical revision rate.

Conclusions: Adults with CRS who require surgical intervention have higher rates of atopy when compared with the general popu-lation. Atopy and asthma are good predictors of more severe radio-logic findings. Neither atopic status nor asthma, however, predicts surgical outcome or revision rate. These findings support the uni-fied airway model of generalized airway inflammation.