Peripheral eosinophilia in the diagnosis of chronic rhinosinusitis

To determine the relationship between peripheral blood eosinophilia and chronic rhinosinusitis.

A retrospective review was conducted of consecutive operative cases during 1 calendar year. The preoperative complete blood count (CBC) were tabulated for three groups of patients: those undergoing endoscopic sinus surgery, those undergoing septoplasty with turbinate reduction alone, and a nonrhinologic control group. Statistical analysis was performed to determine differences in the components of the CBC among these three groups of patients and to identify significant associations between abnormal peripheral eosinophil counts and these diagnoses.

A total of 87, 32, and 92 patients were identified for the endoscopic sinus surgery (ESS), septoplasty, and control groups, respectively. Significant differences in the percentages of eosinophils, lymphocytes, and neutrophils were noted among the three groups (P <.05). Comparison among groups indicated that ESS patients had significantly higher percent peripheral eosinophilia when compared with both the control group and septoplasty group (P <.001 and P =.010, respectively); no significant difference was noted between the septoplasty group and the control group (P =.627). The sensitivity and specificity of the peripheral eosinophil count for chronic sinusitis were 49.4% and 84.7%, respectively.

The peripheral eosinophil count in chronic sinusitis is elevated compared with both a nonrhinologic control group and a group of patients with septal deviation. Furthermore, abnormally elevated eosinophil counts are associated with chronic sinusitis but not chronic rhinitis alone. However, this association is not strong enough to be used in the diagnosis of chronic sinusitis because of poor sensitivity.