Radiologic sinus inflammation and symptoms of chronic rhinosinusitis in a population-based sample

Area of Science:

• Otolaryngology
• Radiology
• Epidemiology

Background:

• Chronic rhinosinusitis (CRS) is often defined by symptoms alone, potentially missing objective sinus findings.
• Previous epidemiological studies lacked assessment of radiologic sinus opacification.

Purpose of the Study:

• To determine the prevalence of radiologic sinus opacification and CRS defined by co-occurring symptoms and opacification in a general population.
• To identify factors associated with sinus opacification and CRS in the general population.

Main Methods:

• A population-based sample of 646 participants underwent symptom questionnaires and sinus CT scans.
• Chronic rhinosinusitis with symptoms (CRS_S) was defined by guidelines; objective radiologic inflammation (CRS_O) used Lund-Mackay scores.
• Participants with both symptoms and opacification were classified as CRS_S+O. Weighted analyses estimated prevalence in the source population.

Main Results:

• Sinus opacification (Lund-Mackay scores ≥3) was more prevalent in men (11.1%) than women (1.7%).
• Prevalence of CRS_S+O was higher in men (8.8%) compared to women (0.45%).
• Men showed greater opacification in frontal, anterior ethmoid, and sphenoid sinuses compared to women.

Conclusions:

• Sinus opacification is more common in men and occurs in distinct sinus locations by sex.
• Male sex, migraine headaches, and a history of sinus surgery are associated with increased odds of CRS_S+O.