Sicca Symptoms and their Association with Chronic Rhinosinusitis in a Community Sample

Abstract

Objective:To determine associations between sicca symptoms, chronic rhinosinusitis (CRS) symptoms and asthma in a community survey.Methods:Data was obtained from the Spring 2009 South Australian Health Omnibus Survey which sampled, via interviewer administered questionnaire, 3007 individuals aged 15 years and over whose socio-demographic distribution corresponded to South Australian population estimates. Respondents were asked a range of questions relating to the presence of persistent dry eyes or dry mouth, CRS and medically diagnosed nasal polyps and asthma. Relationships between symptoms were explored using maximum likelihood dependency tree analysis.Results:The respective population prevalences were: dry mouth (5.9%), dry eyes (8.6%), nasal polyps (3.8%), CRS (13.2%) and asthma (12.0%). The overall prevalence of sicca symptoms (dry eyes or dry mouth) was 12.4%. Dependency tree analysis revealed the expected symptom clustering between (1) sicca symptoms and their association with female gender and increasing age and (2) CRS, nasal polyps and asthma (one airway hypothesis). However there was also an association between dry eyes and CRS (OR 2.5, 95% CI 1.9, 3.4), which was in fact stronger than the association between CRS and asthma (OR 1.9, 95% CI 1.4, 2.5).Conclusions:Sicca symptoms are common in the community. Our novel finding of a strong association between dry eyes and CRS suggests that further research into the relationship between airway inflammation and sicca symptoms is required. These findings may have particular relevance to Sjögren’s syndrome (SS) in both its primary and secondary forms.

Diagnostic utility of Acoustic Radiation Force Impulse (ARFI) imaging in primary Sjoegren`s syndrome

“…While xerostomia and xerophthalmia are often attributed to environmental factors (temperature-controlled air, screen handling), drugs (contraceptives, beta-blockers, psychotropic drugs, etc. ), and systemic diseases such as diabetes mellitus or thyroid disorders, approximately 2 % of the adult population suffers from pSS [1][2][3][4][5], which represents the most important rheumatic disorder affecting the head and neck [6]. The slowly progressive clinical course and the lack of symptom specificity often dramatically prolong the time to diagnosis.…”

“…Apart from the 'natural' glandular atrophy that occurs in the elderly, environmental factors such as temperaturecontrolled air, screen handling, ozone, dust, solvent vapours, contraceptives, beta-blockers, and psychotropic drugs are known to induce sicca symptoms [1,2]. A recent study demonstrated an association with chronic rhinosinusitis [3]. Diabetes mellitus, thyroid diseases, and autoimmunity, on the other hand, consistently caused xerostomia/xerophthalmia [2,4,5].…”

Real-World Database Examining the Association between Sjögren’s Syndrome and Chronic Rhinosinusitis

“…Researchers have provided controversial conclusions regarding the predisposition of patients with SS toward CRS, and studies evaluating the relationship between SS and CRS are scant [3,7]. To the best of our knowledge, this is the first population-based study with long-term follow-up to investigate the risk of CRS in patients with SS.…”

“…Sjögren’s syndrome (SS) is a chronic autoimmune disorder characterized by the lymphocytic infiltration of exocrine glands, particularly the salivary and lacrimal glands, which can lead to xerostomia and keratoconjunctivitis sicca [3,4,5]. In addition, SS may involve dryness and chronic inflammation of the sinonasal mucosa, which may cause CRS [3].…”

“…Min et al reported systemic lupus erythematosus and rheumatoid arthritis as risk factors for CRS [6]. Lester et al found a strong association between sicca symptoms and CRS [3]. SS is a major autoimmune disease, and patients with SS present typical sicca symptoms.…”