Aeroallergen sensitivities and development of chronic rhinosinusitis in 13 adults who initially had allergic rhinitis

Sedaghat, Ahmad R.; Gray, Stacey T.; Phillips, Katie; Caradonna, David S.

doi:10.1111/coa.12644

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…[1][2][3] CRS affects patients through not only chronic sinonasal symptomatology but also acute exacerbations and worsening of comorbid pulmonary disease. [4][5][6] There are likely multiple pathophysiologic mechanisms of CRS, [7][8][9][10][11] which likely contribute to the various CRS subtypes and endotypes. 12 Among all forms of CRS, smoking is known to contribute to disease burden.…”

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confidence: 99%

Reversal of Smoking Effects on Chronic Rhinosinusitis after Smoking Cessation

Phillips

Hoehle

Bergmark

et al. 2017

Otolaryngol.--head neck surg.

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Objective To understand whether the impact of smoking on chronic rhinosinusitis (CRS) is reversible after smoking cessation. Study Design Cross-sectional study. Setting Academic tertiary care rhinology clinic. Subjects and Methods A total of 103 former-smoker CRS patients and 103 nonsmoker CRS patients were prospectively recruited. The primary outcome measure was sinonasal symptom severity measured with the 22-item Sinonasal Outcomes Test (SNOT-22), and secondary outcome measures were general health-related quality of life (QOL) measured with the 5-dimensional EuroQol visual analog scale (EQ-5D VAS) and patient-reported CRS-related antibiotic and oral corticosteroid usage in the past year. Outcome measures were compared between cohorts and checked for association with time since cessation of smoking for former smokers. Results Compared with nonsmokers, former smokers had worse SNOT-22 score ( P = .019) and EQ-5D VAS score ( P = .001) and reported using more CRS-related antibiotics ( P = .003) and oral corticosteroids in the past year ( P = .013). In former smokers, every year was associated with a statistically significant improvement in SNOT-22 score (β = -0.48; 95% CI, -0.91 to -0.05; P = .032), EQ-5D VAS score (β = 0.46; 95% CI, 0.02-0.91; P = .046), and CRS-related oral corticosteroid use (relative risk = 0.95; 95% CI, 0.91-0.98; P = .001). Given the differences in our study outcome measures between former smokers and nonsmokers, we estimate that the reversible impacts of smoking on CRS may resolve after 10 to 20 years. Conclusions CRS patients who are former smokers have worse sinonasal symptomatology, QOL, and CRS-related medication usage than nonsmokers. Every year since cessation of smoking is associated improvements in sinonasal symptomatology, QOL, and CRS-related oral corticosteroid use, potentially reaching nonsmoker levels after 10 to 20 years.

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confidence: 99%

Reversal of Smoking Effects on Chronic Rhinosinusitis after Smoking Cessation

Phillips

Hoehle

Bergmark

et al. 2017

Otolaryngol.--head neck surg.

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“…CRS is defined clinically by a pattern of sinonasal symptomatology, including nasal obstruction, lasting greater than 12 weeks [1][2][3] and is thought to be caused by multiple pathophysiologic mechanisms, including atopy, immune dysfunction, and infection. [4][5][6][7][8] CRS causes a significant detriment in patient quality of life 9 (QOL) related to chronic symptomatology, acute CRS exacerbations, 10 and exacerbations of comorbid pulmonary disease. 11 The decrease in quality of life associated with CRS may be worse than the detriment seen in other chronic disorders, such as asthma and cardiac disease.…”

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confidence: 99%

“…There is a growing body of literature associating chronic rhinosinusitis (CRS), a disease characterized by chronic inflammation of the sinonasal mucosa, with depression. CRS is defined clinically by a pattern of sinonasal symptomatology, including nasal obstruction, lasting greater than 12 weeks 1‐3 and is thought to be caused by multiple pathophysiologic mechanisms, including atopy, immune dysfunction, and infection 4‐8 . CRS causes a significant detriment in patient quality of life 9 (QOL) related to chronic symptomatology, acute CRS exacerbations, 10 and exacerbations of comorbid pulmonary disease 11 .…”

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confidence: 99%

Association between Nasal Obstruction and Risk of Depression in Chronic Rhinosinusitis

Phillips

Hoehle

Bergmark

et al. 2017

Otolaryngol.--head neck surg.

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Objective Chronic rhinosinusitis (CRS) is associated with an increased risk for depression. Since nasal obstruction is a symptom of CRS that is treatable, we sought to characterize its impact on the risk for depression in CRS. Study Design Prospective cross-sectional cohort of 94 patients with CRS. Setting Academic tertiary care rhinology clinic. Subjects and Methods Patients with CRS without vasculitis, cystic fibrosis, sarcoidosis, immunodeficiency, or sinonasal malignancy. Risk for depression was assessed with the 2-item Patient Health Questionnaire (PHQ-2) while nasal obstruction was assessed with the Nasal Obstruction Symptom Evaluation (NOSE) instrument. Multivariate logistic regressions were performed to seek association between NOSE and PHQ-2 scores. Analysis of receiver operating characteristic (ROC) curves defined a NOSE threshold for detecting participants with PHQ-2 greater than 1. Results Of the 94 participants, the mean NOSE score was 47.3, and 29.8% of patients had a PHQ-2 score greater than 1. We found an elevated NOSE score was associated with having a PHQ-2 score greater than 1 (adjusted odds ratio, 1.03; 95% CI, 1.01-1.05; P = .001). Alternatively, a 23-point increase in NOSE score was associated with a 1.5-fold increase in PHQ-2 score (adjusted relative risk, 1.02; 95% CI, 1.01-1.03; P < .001). ROC analysis identified an optimal NOSE threshold of 42.5 for detecting participants with PHQ-2 greater than 1, with 82.1% sensitivity and 50.0% specificity. Conclusions The impact of nasal obstruction is associated with an increased risk for depression in patients with CRS. Assessing for severe nasal obstruction may help to identify those patients with CRS with the highest risk for depression.

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“…Chronic rhinosinusitis (CRS) is an inflammatory disease of the paranasal sinus mucosa that causes a significant detriment to quality of life, results in billions of dollars in related costs, and has a largely unknown pathophysiology, although multiple possible mechanisms have been proposed . The natural history of CRS includes chronic nasal and extranasal symptoms as well as acute and transient increases in symptoms referred to as acute exacerbations of CRS (AECRS) .…”

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confidence: 99%