title: Asthma and sinusitis: association and implication.
abstract: BACKGROUND
  Sinusitis occurs frequently in asthmatic patients. Epidemiologic data on sinusitis and lower airway disease must be evaluated with caution because they are based mostly on symptoms and do not include nasal endoscopic or computed tomography (CT) findings. Clinical support and evidence for this association are lacking. We evaluated the impact of sinusitis on lower airway disease in patients with well-characterized asthma.
  
  
  METHODS
  Subjects (n = 188) completed a questionnaire designed to provide information about their signs and symptoms related to asthma, allergic rhinitis (AR) and sinus disease. Patients (n = 104) were divided into four groups based on the presence or absence of sinusitis and/or AR. Clinical findings were compared in asthma patients with and without diagnosed sinusitis, by an otorhinolaryngologist or based on sinus CT findings.
  
  
  RESULTS
  The prevalence of sinusitis in patients with asthma was 36.7%. Sinus CT scan abnormalities were detected in 66.3% of patients with asthma. The scans revealed abnormal opacity in 17.9% of asthmatic patients without a history of sinusitis. There was a significant correlation between the rate of asthma severity and sinus morphologic abnormalities in patients with and without sinusitis. In adult-onset asthma (>or=16 years old), sinusitis frequently preceded asthma, whereas in non-adult-onset asthma (<16 years old) it preceded sinusitis. The complication rate of sinusitis in asthmatic patients was significantly higher in adult-onset asthma than in non-adult-onset asthma.
  
  
  CONCLUSIONS
  Our findings suggest that bronchial asthma is closely related to sinusitis and the onset age of asthma is important when considering allergic disease frequency. Whether sinus disease directly affects the intensity of bronchial inflammation remains to be elucidated.
authors.affiliation: Division of Respiratory Disease, Osaka Minami Medical Center, Kawachinagano City, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsuno
authors.forename: Emiko
authors.initials: E
authors.lastname: Ono
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Takenaka
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Okubo
authors.forename: Keiko
authors.initials: K
authors.lastname: Takatani
authors.forename: Takuya
authors.initials: T
authors.lastname: Ueno
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nishitake
authors.forename: Shigeo
authors.initials: S
authors.lastname: Hiroshige
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sawabe
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Eishi
authors.initials: E
authors.lastname: Miyazaki
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kumamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000473:pathology; D015995:Prevalence; D012220:Rhinitis / Q000150:complications; D012852:Sinusitis / Q000150:complications*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed