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Symptoms in chronic rhinosinusitis with and without nasal polyps
Dirk A E Dietz de Loos1, Claire Hopkins, Wytske J Fokkens
1Department of Otorhinolaryngology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. D.A.DietzdeLoos@amc.nl
The Laryngoscope
|January 3, 2013
Summary
Distinguishing chronic rhinosinusitis with nasal polyps (CRSwNP) from chronic rhinosinusitis without nasal polyps (CRSsNP) based on clinical impression alone is challenging. While some symptoms like rhinorrhea and smell loss are more common in CRSwNP, and facial/ear pain in CRSsNP, significant symptom overlap exists.
Area of Science:
- Otolaryngology
- Rhinology
- Medical Diagnostics
Background:
- Chronic rhinosinusitis (CRS) is classified into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP).
- Diagnosis is typically based on clinical criteria, endoscopy, and imaging.
- Clinical impression alone may not always accurately differentiate between CRSwNP and CRSsNP.
Purpose of the Study:
- To analyze symptom score differences between CRSwNP and CRSsNP patients.
- To evaluate the feasibility of distinguishing CRSwNP from CRSsNP based solely on clinical impression.
Main Methods:
- A retrospective case-control study design was employed.
- Rhinosinusitis Outcome Measure 31 (RSOM-31) questionnaires were collected from 234 CRS patients.
- Symptom scores and prevalence were compared between CRSwNP and CRSsNP groups, correlating with endoscopic and CT scan findings.
Main Results:
- While overall RSOM-31 scores showed considerable overlap, significant differences were observed in specific symptoms.
- CRSwNP patients reported higher and more frequent "rhinorrhea" and "decreased sense of taste or smell."
- CRSsNP patients reported higher and more frequent "facial pain" and "ear pain."
Conclusions:
- Despite statistically significant differences in certain symptoms, considerable overlap persists.
- Accurate differentiation between CRSwNP and CRSsNP solely on clinical impression remains difficult.
- Objective diagnostic tools like endoscopy and CT scans are crucial for definitive diagnosis.
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