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Radiological score, asthma and NSAID-exacerbated respiratory disease predict relapsing chronic rhinosinusitis
Markus Lilja1,2,3, Anni Koskinen1,2, Sari Hammarèn-Malmi1
1Department of Allergology, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Objectives:
The aim was to evaluate the predictive potential of Sinonasal Radiological (SR) and the Lund-Mackay (LM) score of sinus computed tomography (CT) scans on postoperative relapses of chronic rhinosinusitis (CRS).
Materials And Methods:
CRS patients (n = 483, 12-80 years) underwent routine sinus CT scans. The SR score was defined by obstructed frontal recess (0 = no, 1 = yes) and visualization of middle and inferior turbinate (0 = anatomy can be easily visualized, 1 = anatomy cannot be easily visualized) on each side (a total of 0-6 points). Associations were analyzed by nonparametric, survival and Cox's proportional hazard models.
Results:
Revision endoscopic sinus surgery (ESS) was performed in 133 (28.0%) patients on average (min-max) of 3.2 (0-12) years after performing the sinus CT scans. Of the 408 patients who underwent the baseline ESS, high preoperative SR or LM scores significantly predicted revision ESS (p < 0.001) and peroral corticosteroid courses purchased during the follow-up (p = 0.009 and p < 0.001, respectively for SR- and LM-scores). In multivariable analysis, both SR score and asthma and/or NSAID exacerbated respiratory disease (N-ERD) were significantly associated with revision ESS risk (p = 0.035, p = 0.007, respectively).
Conclusion:
LM and SR and a history of asthma or N-ERD predict CRS relapses, which may help in decision-making.
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