The relationship between atopy and chronic rhinosinusitis.
BACKGROUND
The aim of this study was to determine whether atopy influences either clinical and radiological severity or surgical revision rates in patients with chronic rhinosinusitis (CRS).


METHODS
Patients who had been scheduled for endoscopic sinus surgery were classified as having CRS or nasal polyposis. Their atopic status was determined by ImmunoCAP testing. Disease severity was assessed clinically by the Lund symptom and Sino-Nasal Outcome Test 20 (SNOT-20) quality-of-life scores and radiologically by the Lund-Mackay CT score.


RESULTS
One hundred ninety-three consecutive patients with rhinosinusitis were included in the study. The prevalence of atopy in this group was found to be 30%. No association was found between atopic status and Lund symptom scores. Analysis of the SNOT-20 scores indicated that atopic patients had higher sneezing scores (p < 0.03), reduced productivity (p < 0.01), and reduced concentration (p < 0.01). The mean CT score was significantly higher in the atopic patients than in nonatopic patients overall (14.2+/-1.6 versus 12.2+/-1.3; p = 0.05), although within each of the clinical subgroups no statistically significant relationship was observed between a patients' atopic status and their CT scores. The rate of revision surgery was not significantly different between atopic and nonatopic patients.


CONCLUSIONS
These results suggest that atopic status has minimal impact on the severity of CRS.
Robinson
Simon
S
Wakefield Hospital, Wellington, New Zealand.
Douglas
Richard
R
Wormald
Peter-John
PJ
D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012220:Rhinitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012720:Severity of Illness Index; D012852:Sinusitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery
D000888:Antibodies, Anti-Idiotypic; D007073:Immunoglobulin E