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Prevalence of Central Compartment Atopic Disease (CCAD): a systematic review and meta-analysis
Robbi Miguel G Falcon1, Ma Angela Diarota2, Ross Ivan T Gammad2
1College of Medicine, University of the Philippines Manila, Manila, Philippines. rgfalcon@up.edu.ph.
Background:
Central compartment atopic disease (CCAD) is a subtype of chronic rhinosinusitis characterized by polypoid edema and mucosal changes localized to the central sinonasal compartment, particularly the middle turbinate, superior turbinate, and posterosuperior nasal septum, in association with inhalant allergy. Despite increasing recognition, its epidemiologic burden remains poorly defined.
Methods:
All studies reporting the proportion of CCAD among CRS were extracted from OVID Medline, Scopus, and EBSCO CINAHL. A review of title and abstracts was done independently by seven reviewers. The quality of the studies was assessed using the Newcastle-Ottawa scale. Meta-analysis was performed using R v.4.1.1, using the 'meta', 'tidyverse', and 'metafor' packages (version 4.19-0).
Results:
Seven studies from the United States and Asia were included in the study. The pooled proportion of CCAD was 23.0% (95% CI 15.0%-33.0%). Subgroup analyses suggested variability by region being higher in Asia and sex, showing higher prevalence in males; however, these analyses were exploratory in nature and intended to identify potential sources of heterogeneity rather than establish definitive subgroup differences.
Conclusion:
CCAD represents a substantial proportion of chronic rhinosinusitis with nasal polyps (CRSwNP) cases globally, though estimates are limited by marked heterogeneity and inconsistent diagnostic criteria. Standardized case definitions and wider geographic surveillance are essential to better characterize the global burden and phenotypic diversity of CCAD.
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