The Frequency of Chronic Rhinosinusitis/Nasal Polyp in COPD and Its Effect on the Severity of COPD

Abstract

This study aimed to investigate the effect of chronic rhinosinusitis/nasal polyposis on the severity of COPD and to find out whether the 'united airway disease' hypothesis is valid for COPD. The study enrolled 90 patients diagnosed and staged according to criteria of an international guideline for diagnosis and management of COPD. The patients in stages I and II were classified as Group 1 and the patients in stages III and IV as Group 2. All the patients were questioned about the presence of major and minor criteria of sinusitis, underwent paranasal sinus computed tomography (PNS-CT) scans, and answered a questionnaire based on a quality of life test for sinusitis (SNOT-20). Sinusitis was present in 48 (53%) patients according to criteria of major and minor symptoms, and in 58 (64%) patients according to Lund-Mackay scoring system of PNS-CT. There was no significant difference in CT score between Group 1 and Group 2 (2.3 +/- 0.5 vs. 2.1 +/- 0.4, p > 0.05). However, the frequency of minor symptoms was greater in Group 2. SNOT-20 score was significantly higher in Group 2 than in Group 1 (28.7 +/- 1.7 and 22.2 +/- 1.9, respectively, p = 0.014). A significant correlation was determined between Lund-Mackay and SNOT-20 scores. The presence of CRS should be assessed in COPD patients, especially in those with severe disease. Further research is needed to disclose possible common immunopathological mechanisms in the pathogeneses of COPD and CRS.

Sinonasal inflammation in COPD: a systematic review

“…Interestingly, there was no significant correlation between SNOT-20 and SGRQ, suggesting that upper and lower airway symptoms independently affect the QoL in COPD patients. The SNOT-20 questionnaire was also used in 90 COPD patients living in Turkey [5]. Sinonasal symptoms were present in 53% and SNOT-20 scores were significantly higher in more severe cases of COPD.…”

“…HURST et al [45], a group from England that has contributed markedly to this area of research over the past 10 years, showed that nasal airway obstruction mirrors the impairment of pulmonary airflow in 51 former and present smokers with mild-severe COPD. In 2011, KELEMENCE et al [5] studied the frequency of sinusitis in patients with COPD; 90 patients (COPD stage I-IV) were included and 48 (53%) had sinusitis. Furthermore, VAN MANEN et al [46] found a strong association between irreversible airway obstruction and sinusitis (OR 6).…”

“…In a casecontrol study, REH et al [21] found a significant association between CRS and SHS exposure either in childhood or at the time of the study. Furthermore, CRS cases that had been exposed to SHS reported more [18] 1992 Cross-sectional study 324 Yes No P COLLINS et al [19] 2002 [44] 2008 Cross sectional study and follow up study 4280 No No No HURST et al [45] 2006 Descriptive study 51 No No S KELEMENCE et al [5] 2011 Descriptive study 90 No No S VAN MANEN et al [46] 2001 Descriptive study 290 No No S ROBERTS et al [4] 2003 Descriptive study 61 No No S CORSICO et al [47] 2007 Descriptive study 212 No Yes…”

“…in patients with chronic rhinosinusitis (CRS) and nonallergic rhinitis (NAR) [1,2]. In COPD, the airway too appears to be united since patients with COPD frequently report sinonasal symptoms [3][4][5].…”

The Impact of Endonasal Endoscopic Sinus Surgery on Patients with Chronic Pulmonary Diseases

“…Hens et al (2008) and Piotrowska et al (2010) found higher endoscopic rhinosinusitis symptom scores in patients with COPD than in the healthy population [6,7]. In 90 patients with COPD in different disease stages, Kelemence et al detected clinical criteria for rhinosinusitis in 53% of the patients [8]. In a review, Kim and Rubin (2007) reported that 75% of all patients with COPD collectively complained of nasal symptoms [9].…”