A positive correlation between autonomic nervous system function and endoscopic disease severity in chronic...

The autonomic nervous system (ANS) regulates respiratory mucosal inflammation and is linked to various airway diseases. However, the relationship between ANS dysfunction and chronic rhinosinusitis (CRS) has not been fully investigated. This study aimed to explore the association between ANS and CRS using a battery of quantitative autonomic function tests.

Patients with CRS undergoing surgery were prospectively enrolled. Subjective evaluation of disease severity was assessed using the sino-nasal outcome test-22 questionnaires for CRS and the 31-item composite autonomic symptom score questionnaires for ANS dysfunction, while computed tomography and endoscopic scores represented objective severity. A battery of autonomic function tests was conducted, and the results were used to generate the modified composite autonomic scoring scale (mCASS) to provide a quantitative evaluation of ANS function.

A total of 49 patients were enrolled. The most common dysautonomic symptoms were dry mouth (73.5%), dizziness (71.4%), and dry eyes (55.1%). Twenty-six patients (53.1%) had a positive mCASS score, indicating abnormal autonomic function. Within the subdomains, most abnormalities were observed in the sudomotor score (28.6%). The mCASS score showed a positive correlation with the endoscopic score, with marginal significance. Notably, the sudomotor subdomain score was significantly correlated with the endoscopic score.

A significant correlation was found between objective autonomic nervous system function and severity of chronic rhinosinusitis, particularly in the sudomotor subdomain, suggesting a link between peripheral cholinergic activity and sinonasal inflammation. Further research is needed to clarify the underlying mechanisms.