Association of Allergic Biomarkers in Patients with Chronic Rhinosinusitis With or Without Asthma

Background Chronic rhinosinusitis and asthma are considered under unified airway diseases which describes the shared epidemiologic and pathophysiologic relationship among the chronic inflammatory diseases of the upper and lower airways Objective To assess the asthma in patients with chronic rhinosinusitis and determine the relationship of allergic biomarkers, tissue eosinophilia and radiological bone changes in patients with chronic rhinosinusitis with or without asthma. Method Prospective study involving 74 adult patients attending the Department of Otorhinolaryngology and Pulmonology at the Kathmandu University Dhulikhel Hospital for treatment of chronic rhinosinusitis and / or asthma and for functional endoscopic sinus surgery between May 2023 and May 2024. Absolute eosinophil count, total serum IgE and spirometry tests were performed. Radiological evidence of osteitis and tissue eosinophilia from surgical samples was evaluated. Correlations between allergic biomarkers,spirometry values, tissue eosinophilia, and radiological bone changes were determined in patients of chronic rhinosinusitis with or without asthma using the Mann Whitney U test, Student t test and the chi square test. Result A positive association was observed between the radiological bone score with tissue eosinophilia (p=.018), and smoking (p < 0.001) in between the two groups. Chronic eosinophilic rhinosinusitis was observed in 39 (52.7%) patients. 15 patients with Chronic rhinosinusitis had asthma ,and among these asthmatic patients 11 had eosinophilic chronic rhinosinusitis. Mild osteitis was evident in 34 (45.9%) ,moderate osteitis in 39 (52.7%) and severe in 1 (1.4%). Among 15 asthmatic patients, 10 had moderate osteitis and 5 had mild osteitis. Conclusion A rigorous exentration of osteitic bony nidus appears necessary for successful treatment outcomes in all chronic rhinosinusitis patients and to prevent acute exacerbation in the asthmatic group of chronic rhinosinusitis patients.