title: Association between severity of asthma and degree of chronic rhinosinusitis.
abstract: BACKGROUND
  There is a clinical association between asthma and chronic rhinosinusitis (CRS). This study was designed to determine whether severity of coexistent asthma affects the clinical presentation of CRS.
  
  
  METHODS
  Cross-sectional analysis was performed of prospectively collected data in 187 patients with CRS who were evaluated in a large, tertiary academic nasal and sinus center. Patients were stratified into three groups based on asthma status using National Institutes of Health criteria: (1) nonasthmatic, (2) intermittent/mild asthma, (3) or moderate/severe asthma.
  
  
  RESULTS
  Mean Lund-Mackay scores were 9.7, 11.6, and 15.6, respectively. ANOVA testing with post-hoc Tukey analysis revealed that Lund-MacKay scores were significantly greater in group 3 than either group 1 (p < 0.05) or group 2 (p < 0.01). The prevalence of allergic sensitization was 72.4, 82.8, and 100% in groups 1, 2, and 3, respectively (p = 0.03). The prevalence of nasal polyposis was 31.4% in group 1, 48.3% in group 2, and 94.4% in group 3 (p < 0.0001). No differences were observed regarding demographic factors or the incidence of the triad of aspirin sensitivity, asthma, and nasal polyposis among those with different severities of asthma.
  
  
  CONCLUSIONS
  Increasing severity of asthma is associated with advancing radiological severity of CRS and a greater prevalence of allergic sensitization and nasal polyposis. This large adult series shows that asthma severity may have a significant correlation with the presentation of CRS. This study adds to the growing support for the unified airway theory.
authors.affiliation: Medical School class, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Lin
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Chandra
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Tan
authors.forename: Whitney
authors.initials: W
authors.lastname: Zirkle
authors.forename: David B
authors.initials: DB
authors.lastname: Conley
authors.forename: Leslie C
authors.initials: LC
authors.lastname: Grammer
authors.forename: Robert C
authors.initials: RC
authors.lastname: Kern
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schleimer
authors.forename: Anju T
authors.initials: AT
authors.lastname: Peters
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps; D009316:National Institutes of Health (U.S.); D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D012720:Severity of Illness Index; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D014481:United States