Rhinosinusitis without nasal polyps in COPD

Area of Science:

• Respiratory Medicine
• Otolaryngology

Background:

• The united airway disease concept links rhinosinusitis (RS) and chronic obstructive pulmonary disease (COPD), but requires further validation.
• Previous studies faced methodological limitations, necessitating investigation into the RS and COPD relationship.

Purpose of the Study:

• To determine the prevalence of RS without nasal polyps (RSsNP) in COPD patients.
• To assess sinonasal symptom severity in COPD patients.
• To evaluate the diagnostic accuracy of sinonasal symptoms for RSsNP in COPD.

Main Methods:

• An observational cross-sectional study included 90 COPD patients and 93 controls.
• Diagnosis of RS and COPD followed EPOS 2012 and GOLD guidelines, respectively.
• Symptom assessment used the SNOT-22 questionnaire and visual analogue scales (VAS); nasal endoscopy confirmed RS diagnosis and type.

Main Results:

• RSsNP was found in 51% of COPD patients, threefold higher than in controls (p<0.001).
• Nasal discharge (72%) and obstruction (62%) were the most common symptoms in COPD patients.
• Composite VAS for rhinological symptoms showed better diagnostic accuracy for RSsNP than facial symptoms.

Conclusions:

• RSsNP is significantly more prevalent in COPD patients compared to controls.
• COPD is strongly associated with RSsNP, supporting the united airway disease concept.
• Sinonasal symptoms, particularly rhinological ones, aid in diagnosing RSsNP in COPD patients.