title: Relationship between olfactory acuity and peak expiratory flow during postoperative follow-up in chronic rhinosinusitis associated with asthma.
abstract: OBJECTIVE
  The link between nasal and bronchial disease has been studied extensively for chronic rhinosinusitis and asthma. The concept of "united airway allergy" has become widely accepted in the past decade. We evaluated the relationship between the upper and lower airways during follow-up after endoscopic sinus surgery by monitoring sinonasal and pulmonary functions.
  
  
  METHODS
  Thirty-nine subjects with chronic rhinosinusitis associated with bronchial asthma were entered in this study. A self smell test using stick-type odorant materials was carried out daily to evaluate postoperative recurrence of sinonasal disease. Each patient was assessed for peak expiratory flow (PEF) 3 times daily.
  
  
  RESULTS
  The average (+/- SD) scores of initial symptoms were 8.3 +/- 2.2, which was significantly decreased to 1.5 +/- 1.4 by 3 months after operation. During postoperative follow-up, 25 of 39 patients showed no decrease in PEF, whereas the other 14 patients had at least 1 episode of a significant decline in PEF. In the postoperative course, with respect to the self smell test, 24 patients showed no aggravation of smell, but 15 patients had episode(s) of decreased olfaction. Twelve patients demonstrated worsening on the smell test concomitant with a decreased PEF. A discrepancy between olfactory acuity and pulmonary function was recognized in 5 patients. There were 22 patients with a good prognosis of parameters of both the upper and lower airways.
  
  
  CONCLUSIONS
  Daily monitoring of both upper and lower respiratory tract functions clearly revealed dual relationships, indicating that worsening of sinusitis accompanies asthma exacerbation. Appropriate measures of the upper and lower airways following endoscopic sinus surgery can be used to predict patient outcome.
authors.affiliation: Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan.
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Ikeda
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yokoi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kusunoki
authors.forename: Tatuya
authors.initials: T
authors.lastname: Saitoh
authors.forename: Toru
authors.initials: T
authors.lastname: Yao
authors.forename: Kaori
authors.initials: K
authors.lastname: Kase
authors.forename: Akira
authors.initials: A
authors.lastname: Minekawa
authors.forename: Ayako
authors.initials: A
authors.lastname: Inoshita
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate / Q000502:physiology*; D012220:Rhinitis / Q000453:epidemiology / Q000503:physiopathology*; D012852:Sinusitis / Q000453:epidemiology / Q000503:physiopathology*; D012903:Smell / Q000502:physiology*; D055815:Young Adult