The Unified Airway: Does Asthma Influence Paranasal Sinus Pneumatization?

Abstract

Asthma has been implicated as a driving force in lower airway remodeling; however, its effect on upper airway development has not been studied. Clinical disease, particularly cystic fibrosis (CF), has been associated with anatomical paranasal sinus variation, although the mechanism for these variations remains unclear. The purpose of this study was to determine whether asthma is associated with altered sinus pneumatization. Five hundred ninety-one computed tomography scans, including 303 adolescents (age 13-18) and 288 adults (age > 18), were evaluated using the Assessment of Pneumatization of the Paranasal Sinuses (APPS) instrument. The APPS score is validated for assessing anatomical variation and total sinus volume. A diagnosis of asthma was ascertained from the medical record, and patients with CF were included as a positive control group. Patients with asthma had mean APPS score of 9.66, compared to 9.85 for participants without asthma ( P = .585). Subgroup analysis demonstrated similar findings among adults ( P = .817) and adolescents ( P = .585). Patients with a diagnosis of CF had significant sinus hypoplasia according to a mean APPS scores of 3.50 ( P < .001). Sinus hypoplasia persisted in both adults ( P < .001) and adolescents ( P < .001) with CF. The presence of asthma is not associated with altered paranasal sinus pneumatization. In contrast, CF is associated with significantly reduced sinus pneumatization. These findings suggest that aberrant sinus pneumatization may not be a feature of asthma and that chronic mucosal respiratory disease is not a generalizable cause for altered paranasal sinus pneumatization.

Bidirectional association between asthma and chronic rhinosinusitis: Two longitudinal follow-up studies using a national sample cohort

“…There may be a chance that the J33 code is missing during the process. On the contrary, Marino et al discovered that comorbid asthma did not impair sinus pneumatization and was not associated with the Lund-Mackay computed tomography (CT) score reflecting CRS disease severity 36 . In CRSwNP patients, comorbid asthma had no impact on tissue eosinophilia and CT score 37 .…”

Pediatric sellar teratoma – Case report and review of the literature

“…However, due to her age and the concomitant diagnosis of CF, known to be associated with hypoplasia and markedly reduced pneumatization of the paranasal sinuses, a non-pneumatized (conchal type) sphenoid was present (Fig. 1 D), making the AAE more challenging [ 21 ]. In addition, gross total resection (GTR) was not considered achievable through an EEA, due to a supra-chiasmatic tumor extension.…”