Association between severity of asthma and degree of chronic rhinosinusitis

Am J Rhinol Allergy. Jul-Aug 2011;25(4):205-8. doi: 10.2500/ajra.2011.25.3613.


Background: There is a clinical association between asthma and chronic rhinosinusitis (CRS). This study was designed to determine whether severity of coexistent asthma affects the clinical presentation of CRS.

Methods: Cross-sectional analysis was performed of prospectively collected data in 187 patients with CRS who were evaluated in a large, tertiary academic nasal and sinus center. Patients were stratified into three groups based on asthma status using National Institutes of Health criteria: (1) nonasthmatic, (2) intermittent/mild asthma, (3) or moderate/severe asthma.

Results: Mean Lund-Mackay scores were 9.7, 11.6, and 15.6, respectively. ANOVA testing with post-hoc Tukey analysis revealed that Lund-MacKay scores were significantly greater in group 3 than either group 1 (p < 0.05) or group 2 (p < 0.01). The prevalence of allergic sensitization was 72.4, 82.8, and 100% in groups 1, 2, and 3, respectively (p = 0.03). The prevalence of nasal polyposis was 31.4% in group 1, 48.3% in group 2, and 94.4% in group 3 (p < 0.0001). No differences were observed regarding demographic factors or the incidence of the triad of aspirin sensitivity, asthma, and nasal polyposis among those with different severities of asthma.

Conclusion: Increasing severity of asthma is associated with advancing radiological severity of CRS and a greater prevalence of allergic sensitization and nasal polyposis. This large adult series shows that asthma severity may have a significant correlation with the presentation of CRS. This study adds to the growing support for the unified airway theory.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Asthma / complications
  • Asthma / diagnosis
  • Asthma / epidemiology*
  • Asthma / physiopathology
  • Chronic Disease
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps
  • National Institutes of Health (U.S.)
  • Prevalence
  • Prospective Studies
  • Radiography
  • Rhinitis / complications
  • Rhinitis / diagnosis
  • Rhinitis / epidemiology*
  • Rhinitis / physiopathology
  • Severity of Illness Index
  • Sinusitis / complications
  • Sinusitis / diagnosis
  • Sinusitis / epidemiology*
  • Sinusitis / physiopathology
  • United States