چکیده (انگلیسی):

Background: Chronic rhinosinusitis (CRS), which is clinically classified into CRS without nasal polyps
(CRSsNP) and CRS with nasal polyps (CRSwNP), shows considerable geographic differences and heterogeneity.
Eosinophilic (E) CRS with nasal polyps (ECRSwNP) has a higher degree of disease severity and higher
frequency of comorbid asthma. Epidemiologic studies in different ethnic populations have improved understanding
of the pathophysiology of the disease. Here we report the clinical characteristics of Japanese patients
with medically refractory CRS undergoing endoscopic sinus surgery (ESS).
Methods: We recruited a total of 210 CRS patients and assessed them by nasal endoscopy, the Lund-Mackay
score using computed tomography (CT), peripheral eosinophilia and smoking status. We also examined the
comorbidity of asthma, effects of age and lung functions in the patients.
Results: In this study, 13% of CRSwNP patients and 20% of CRSwNP patients with peripheral blood eosinophilia
exhibited obstructive lung dysfunction (FEV1FVC <70%) despite the absence of an asthma diagnosis.
Among elderly nonsmoker patients (60 years) who had never been diagnosed with asthma, 50% of CRSwNP
patients with peripheral blood eosinophilia showed decreased FEV1FVC <70%.
Conclusions: Our findings suggest that asthma is under-diagnosed in CRS patients who undergo ESS, especially
the elderly. Although the association between CRS and asthma has been recognized, increased attention
to the comorbidity of obstructive airway diseases such as asthma is still needed for management of medically
refractory CRS.