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Fractional Exhaled Nitric Oxide for Diagnosing Eosinophilic Chronic Rhinosinusitis: A Systematic Review and
Jae Yoon Lee1, Manal Al Ali2, Soo Whan Kim1
1Department of Otolaryngology-Head and Neck Surgery, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Objective:
The current gold standard for diagnosing eosinophilic chronic rhinosinusitis (ECRS) is tissue biopsy, but due to its invasive nature, there is a need for clinical diagnosis in outpatient settings or presurgical evaluations.
Data Sources:
PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus up to July 2024.
Review Methods:
Compared the fractional exhaled nitric oxide (FeNO) levels between ECRS and non-ECRS patients. The risk of bias across studies was evaluated utilizing the ROBINS-I tool.
Results:
Twelve studies comprising 1159 participants were included. The pooled mean difference in FeNO levels between ECRS and non-ECRS patients was 32.21 ppb (95% CI: [19.36, 45.06], P < .001). The diagnostic odds ratio for FeNO in identifying ECRS was 8.78 (95% CI: [5.70, 13.51], P < .001).
Conclusion:
FeNO levels are significantly elevated in ECRS patients compared to non-ECRS patients. The high diagnostic odds ratio suggests that FeNO has potential as a noninvasive diagnostic tool for ECRS.
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