Computed Tomography Findings Can Help Identify Different Chronic Rhinosinusitis With Nasal Polyp Phenotypes

Area of Science:

• Otolaryngology
• Radiology
• Immunology

Background:

• Chronic rhinosinusitis with nasal polyps (CRSwNP) presents with diverse phenotypes.
• Understanding these phenotypes is crucial for effective management.

Purpose of the Study:

• To investigate computed tomography (CT) findings specific to different CRSwNP phenotypes.
• Correlate CT imaging characteristics with distinct CRSwNP classifications.

Main Methods:

• Retrospective review of 356 patient CT scans (2015-2019).
• Categorization into allergic fungal rhinosinusitis (AFRS), aspirin-exacerbated respiratory disease (AERD), central compartment atopic disease (CCAD), and CRSwNP not otherwise specified (NOS).
• Analysis of Lund-Mackay (LM) scores, septal involvement, olfactory cleft opacification, and middle turbinate positioning.

Main Results:

• AERD and CCAD groups showed higher septal inflammatory involvement and oblique middle turbinate orientation compared to AFRS and CRSwNP NOS.
• Olfactory cleft opacification was significantly increased in the AERD group.
• CCAD patients had lower LM scores, while AFRS patients exhibited greater left-right LM score differences, indicating unilateral disease.

Conclusions:

• CRSwNP comprises distinct subsets with varying clinical and surgical implications.
• Preoperative CT findings offer valuable insights for differentiating CRSwNP phenotypes.
• CT analysis can improve diagnostic accuracy and guide patient counseling for CRSwNP.