Impact of asthma on endoscopic sinus surgery outcomes for chronic rhinosinusitis with polyposis - A cohort study

Lahjaouj, Meryem; Laachoubi, Mohammed; Bouhmadi, Khadija El; Oukessou, Youssef; Rouadi, Sami; Abada, R.; Roubal, M.; Mahtar, M.

doi:10.1016/j.amsu.2021.102386

Cited by 2 publications

(6 citation statements)

References 27 publications

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“…In individuals with CRS without asthma, significant improvement in QOL related to these diseases has been observed following medical and surgical treatment of CRS 5,78–83 . Similarly, ESS consistently improves sinonasal‐specific QOL among individuals with CRSwA, and appears to do so to at least a similar degree as in individuals with CRS without asthma 24,84,85 . A recent retrospective cohort study by Lahjaouj et al.…”

Section: Resultsmentioning

confidence: 93%

“…5,[78][79][80][81][82][83] Similarly, ESS consistently improves sinonasal-specific QOL among individuals with CRSwA, and appears to do so to at least a similar degree as in individuals with CRS without asthma. 24,84,85 A recent retrospective cohort study by Lahjaouj et al demonstrated no difference in 3-and 6-month post-ESS SNOT-22 scores between CRSwA versus CRS-alone cohorts. 24 However, a retrospective study by Zhang et al demonstrated opposite findings, showing a greater QOL benefit among individuals with CRSwA compared with those with CRS alone.…”

Section: Does Ess Improve Sinonasal-specific Qol In Crswa?mentioning

confidence: 98%

“…24,84,85 A recent retrospective cohort study by Lahjaouj et al demonstrated no difference in 3-and 6-month post-ESS SNOT-22 scores between CRSwA versus CRS-alone cohorts. 24 However, a retrospective study by Zhang et al demonstrated opposite findings, showing a greater QOL benefit among individuals with CRSwA compared with those with CRS alone. 84 Le et al performed a meta-analysis examining changes in SNOT-22 scores after ESS.…”

Section: Does Ess Improve Sinonasal-specific Qol In Crswa?mentioning

confidence: 98%

“…15,16,[19][20][21] Similarly, limited data indicate that sinonasal-specific QOL in patients with CRSwA remains largely unchanged compared with patients with CRS alone. [22][23][24] Acute exacerbations of CRS have been linked to poorer asthma control in those with CRSwA, 25 while asthma has been shown to be an important risk factor for both recurrence rate and time to recurrence for the CRSwNP phenotype. [26][27][28][29][30][31][32][33][34] Comorbid asthma also predicts the need for long-term systemic therapy after sinus surgery among individuals with eosinophilic CRS, 35 increased need for CRSrelated health care, 36 increased risk of uncontrolled CRS, 37 and overall greater sinonasal disease burden, as measured by endoscopy and computed tomography (CT).…”

Section: Introductionmentioning

confidence: 99%

“…While limited in scope, data suggest that comorbid CRS is an independent risk factor for increased asthma exacerbations and difficult to control asthma, while comorbid asthma is strongly associated with an exacerbation‐prone phenotype of CRS 15,16,19–21 . Similarly, limited data indicate that sinonasal‐specific QOL in patients with CRSwA remains largely unchanged compared with patients with CRS alone 22–24 . Acute exacerbations of CRS have been linked to poorer asthma control in those with CRSwA, 25 while asthma has been shown to be an important risk factor for both recurrence rate and time to recurrence for the CRSwNP phenotype 26–34 .…”

Section: Introductionmentioning

confidence: 99%

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Management paradigms for chronic rhinosinusitis in individuals with asthma: An evidence‐based review with recommendations

Gill

Alt

Detwiller³

et al. 2023

Int Forum Allergy Rhinol

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BackgroundDespite the significant morbidity associated with chronic rhinosinusitis (CRS) in individuals with asthma (CRSwA), there is a paucity of codified, evidence‐based management strategies for CRS in this population.MethodsUsing PubMed, Embase, and Cochrane Review Databases, a systematic review was performed covering management strategies for CRSwA. A total of 5903 articles were screened, and 70 were included for full‐text analysis. After application of exclusion criteria, 53 articles comprised the qualitative synthesis. The level of evidence was graded and benefit‐harm assessments, as well as value judgment and recommendations, were providedResultsStrong evidence confirms the benefit of oral and topical medications on sinonasal‐specific outcomes in individuals with CRSwA; there is low‐grade evidence demonstrating that these agents improve lung function and/or asthma control. Moderate to strong evidence suggests that endoscopic sinus surgery (ESS) improves both sinonasal‐ and asthma‐specific quality of life. Although there is insufficient to low evidence to indicate that ESS improves pulmonary function in this population, data indicate a positive impact of this intervention on asthma control. Biologic medications strongly improve both subjective and objective sinonasal‐ and asthma‐specific outcomes.ConclusionEvidence supports managing CRS in individuals with CRSwA in a stepwise fashion, starting with traditional nonbiologic oral and topical medication, and escalating to second‐line treatments, such as ESS and biologics. Optimal treatment of individuals who have CRSwA often requires concurrent, directed management of asthma, as not all CRS interventions impact asthma status.

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Section: Resultsmentioning

confidence: 93%