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Objective. This study compared three severity measures for chronic rhinosinusitis with nasal polyps (CRSwNP). The outcome was to identify patients who are eligible for biological therapy. Methods. 330 adult patients with CRSwNP were examined. Nasal polyp score (NPS), sinonasal outcome test (SNOT-22) and clinical-cytological grading (CCG) were compared. Clinical history, past surgery and asthma control test were also considered. Results. Only 45 (13.6%) patients had a contextual positivity to the three severity measures. The concordance among tests was slight/fair. Patients with severe disease (all tests positive) had more impaired parameters. The mixed cytotype (OR = 4.07), nasal obstruction (OR = 10.06), post-nasal drip (OR = 1.98), embarrassment (OR = 2.53) and difficulty falling asleep (OR = 1.92) were significantly associated with severe CRSwNP. Conclusions. To identify candidates for biological therapy, the contextual use of NPS, SNOT-22 and CCG is preferable. In this way, global assessment of CRSwNP, including morphology, inflammation, comorbidity, symptoms and quality of life is possible.

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Nasal cytology is a diagnostic tool that evaluates the normal and pathological aspects of the nasal mucosa, by identifying and counting the cell types and their morphology. Since the cytological characteristics of the infiltrating inflammatory cells could reflect any cytopathological alterations of the blood circulating cells, it is not surprising that pathological findings of patients affected by oncohaematological diseases could also be found in nasal cytology. Therefore, this diagnostic tool could be applied to other branches of medicine including haematology.

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