title: Chronic sinusitis. Relationship of computed tomographic findings to allergy, asthma, and eosinophilia.
abstract: OBJECTIVE
  To develop a technique for evaluating the severity of chronic sinus disease and to examine the correlation with allergy, asthma, and eosinophilia.
  
  
  METHODS
  A survey of 104 patients undergoing surgery for chronic sinusitis.
  
  
  METHODS
  A university hospital ear, nose, and throat clinic.
  
  
  METHODS
  A referral population of adult patients being scheduled for endoscopic sinus surgery was eligible; 104 completed questionnaires and agreed to participate.
  
  
  METHODS
  Computed tomographic scans were reviewed and scored for extent of disease. Serum samples were assayed for total IgE and specific IgE antibodies to common inhalant allergens. Peripheral blood samples were analyzed for total eosinophil count. Surgical biopsy specimens were examined for eosinophilia and cultured for bacteria and fungi.
  
  
  RESULTS
  Extensive disease was present in 39% of subjects and correlated well with asthma, specific IgE antibodies, and eosinophilia, but not with elevated total IgE. Among patients with peripheral eosinophilia, 87% had extensive disease. All cultures grew aerobic bacteria; anaerobes and fungi were uncommon.
  
  
  CONCLUSIONS
  We present a system for quantitation of disease extent using computed tomographic scans of patients with chronic sinusitis. The well-accepted associations of chronic sinusitis with asthma and allergy appear to be restricted to the group with extensive disease. The presence of peripheral eosinophilia in patients with sinusitis indicates a high likelihood of extensive disease.
authors.affiliation: Department of Medicine, University of Virginia Health Sciences Center, Charlottesville 22908.
authors.forename: L J
authors.initials: LJ
authors.lastname: Newman
authors.forename: T A
authors.initials: TA
authors.lastname: Platts-Mills
authors.forename: C D
authors.initials: CD
authors.lastname: Phillips
authors.forename: K C
authors.initials: KC
authors.lastname: Hazen
authors.forename: C W
authors.initials: CW
authors.lastname: Gross
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis / Q000503:physiopathology; D002908:Chronic Disease; D004802:Eosinophilia / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000503:physiopathology; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012852:Sinusitis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D007073:Immunoglobulin E