Chronic sinusitis. Relationship of computed tomographic findings to allergy, asthma, and eosinophilia
L. J. Newman, T. A. Platts-Mills, C. D. Phillips, K. C. Hazen and C. W. Gross
Department of Medicine, University of Virginia Health Sciences Center, Charlottesville 22908.
OBJECTIVE--To develop a technique for evaluating the severity of chronic
sinus disease and to examine the correlation with allergy, asthma, and
eosinophilia. DESIGN--A survey of 104 patients undergoing surgery for
chronic sinusitis. SETTING--A university hospital ear, nose, and throat
clinic. PATIENTS--A referral population of adult patients being scheduled
for endoscopic sinus surgery was eligible; 104 completed questionnaires and
agreed to participate. MAIN OUTCOME MEASURES--Computed tomographic scans
were reviewed and scored for extent of disease. Serum samples were assayed
for total IgE and specific IgE antibodies to common inhalant allergens.
Peripheral blood samples were analyzed for total eosinophil count. Surgical
biopsy specimens were examined for eosinophilia and cultured for bacteria
and fungi. RESULTS--Extensive disease was present in 39% of subjects and
correlated well with asthma, specific IgE antibodies, and eosinophilia, but
not with elevated total IgE. Among patients with peripheral eosinophilia,
87% had extensive disease. All cultures grew aerobic bacteria; anaerobes
and fungi were uncommon. CONCLUSIONS--We present a system for quantitation
of disease extent using computed tomographic scans of patients with chronic
sinusitis. The well-accepted associations of chronic sinusitis with asthma
and allergy appear to be restricted to the group with extensive disease.
The presence of peripheral eosinophilia in patients with sinusitis
indicates a high likelihood of extensive disease.
Total IgE Levels and Peripheral Eosinophilia: Correlation With Mucosal Disease Based on Computed Tomographic Imaging of the Paranasal Sinus
Poznanovic and Kingdom
Arch Otolaryngol Head Neck Surg 2007;133:701-704.
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Diagnostic Classification of Persistent Rhinitis and Its Relationship to Exhaled Nitric Oxide and Asthma: A Clinical Study of a Consecutive Series of Patients
Rolla et al.
Chest 2007;131:1345-1352.
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Allergic rhinitis and sinusitis in asthma: differential effects on symptoms and pulmonary function.
Dixon et al.
Chest 2006;130:429-435.
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Risk factors of frequent exacerbations in difficult-to-treat asthma
ten Brinke et al.
Eur Respir J 2005;26:812-818.
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Evaluation of Paranasal Sinus Mucosa in Coal Worker's Pneumoconiosis: A Computed Tomographic Study
Ozdemir et al.
Arch Otolaryngol Head Neck Surg 2004;130:1052-1055.
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Concomitant Chronic Sinusitis Treatment in Children With Mild Asthma: The Effect on Bronchial Hyperresponsiveness
Tsao et al.
Chest 2003;123:757-764.
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Effect of Omalizumab on Symptoms of Seasonal Allergic Rhinitis: A Randomized Controlled Trial
Casale et al.
JAMA 2001;286:2956-2967.
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Tissue Eosinophilia in Chronic Sinusitis: Quantification Techniques
Bhattacharyya et al.
Arch Otolaryngol Head Neck Surg 2001;127:1102-1105.
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Rhinosinusitis and nasal polyposis in aspirin sensitive and aspirin tolerant patients: are they different?
Kowalski
Thorax 2000;55:84S-86.
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Lactoferrin and Eosinophilic Cationic Protein in Nasal Secretions of Patients with Experimental Rhinovirus Colds, Natural Colds, and Presumed Acute Community-Acquired Bacterial Sinusitis
Niehaus et al.
J. Clin. Microbiol. 2000;38:3100-3102.
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Long-term Follow-up of Pulmonary Function in Patients with Nasal Polyposis
LAMBLIN et al.
Am. J. Respir. Crit. Care Med. 2000;161:406-413.
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Rhinosinusitis and Asthma: Epiphenomenon or Causal Association?
de Benedictis and Bush
Chest 1999;115:550-556.
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A Mouse Model of Acute Bacterial Rhinosinusitis
Bomer et al.
Arch Otolaryngol Head Neck Surg 1998;124:1227-1232.
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