title: Rhinosinusitis in severe asthma.
abstract: BACKGROUND
  Chronic rhinosinusitis is a common comorbidity of asthma. However, sinonasal involvement in severe steroid-dependent asthma is still undefined.
  
  
  OBJECTIVE
  The aim of the study was to evaluate chronic rhinosinusitis in 35 patients with severe steroid-dependent asthma by using a clinical score and coronal computed tomography (CT) scanning.
  
  
  METHODS
  Thirty-five subjects (16 female subjects) with severe asthma requiring daily doses of oral corticosteroids were compared with 34 patients (19 female patients) with mild-to-moderate asthma. Sinonasal involvement was studied by using clinical and CT scores. Airflow obstruction, therapy requirement, and asthma triggering factors were carefully assessed.
  
  
  RESULTS
  The proportion of patients with symptoms of rhinosinusitis was similar in both groups of asthmatic subjects (74% in patients with severe steroid-dependent asthma and 70% in patients with mild-to-moderate asthma). All subjects with steroid-dependent asthma versus 88% of subjects with mild-to-moderate asthma had abnormal CT scan results. The clinical (P <.05) and CT scan (P <.0005) severity scores were higher in the subjects with severe steroid-dependent asthma. In both groups the CT scan scores were correlated to the clinical scores (P <.0001 and P <.006), but only in the mild-to-moderate group were both scores correlated with high significance (P <.002 and P <.0005) to the absolute number of blood eosinophils.
  
  
  CONCLUSIONS
  Frequency of rhinosinusitis in patients with mild-to-moderate or severe steroid-dependent asthma is similar; however, sinonasal involvement, as evaluated by clinical symptoms and CT scan imaging, is significantly greater in the patients with severe steroid-dependent asthma than in those with mild-to-moderate asthma.
authors.affiliation: Service des Maladies Respiratoires and INSERM U 454, Hôpital Arnaud de Villeneuve, CHU de Montpellier, Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Bresciani
authors.forename: L
authors.initials: L
authors.lastname: Paradis
authors.forename: A
authors.initials: A
authors.lastname: Des Roches
authors.forename: H
authors.initials: H
authors.lastname: Vernhet
authors.forename: I
authors.initials: I
authors.lastname: Vachier
authors.forename: P
authors.initials: P
authors.lastname: Godard
authors.forename: J
authors.initials: J
authors.lastname: Bousquet
authors.forename: P
authors.initials: P
authors.lastname: Chanez
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000150:complications*; D002648:Child; D006801:Humans; D009296:Nasal Cavity / Q000000981:diagnostic imaging; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging; D012220:Rhinitis / Q000150:complications*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications*; D014057:Tomography, X-Ray Computed