The Effect of Lower Airway Disease on the Severity of Chronic Rhinosinusitis

ABSTRACT

BACKGROUND AND OBJECTIVES: The relationship between the upper airway disease and the lower airway disease has been studied for several decades. In this study, we propose to investigate the prevalence of asthma, asymptomatic bronchial hyperresponsiveness (aBHR) and small airway disease among the chronic rhinosinusitis (CRS) patients and to evaluate their influence on the severity of CRS. MATERIAL AND METHODS: For the evaluation of lower airway diseases, sixty-eight adult patients with CRS underwent skin prick tests, pulmonary function tests with or without bronchodilator tests and methacholine bronchial provocation tests. The severity of CRS was determined in accordance to three factors ; subjective symptoms, the degree of nasal polyposis and the extent of disease on the CT scan. RESULTS: Asthma, aBHR and small airway disease were diagnosed among seven (10.3%), five (7.4%) and eleven (16.2%) patients, respectively. The lower airway diseases had no significant influence on the severity of CRS. CONCLUSION: CRS patients may have various lower airway diseases, symptomatic or asymptomatic, which should be considered when managing CRS patients.