Sino-nasal characteristics in asthmatic patients.
OBJECTIVE
The Unified Airways Hypothesis suggests an involvement of the upper airways in asthma. We aimed to evaluate the association between subjective sino-nasal complaints, nasal air flow, and sino-nasal quality of life (QOL) in patients with asthma compared with nonasthmatic subjects.


METHODS
Case-control study.


METHODS
A tertiary referral center.


METHODS
Symptoms, quality of life, and nasal airflow were assessed in 91 asthmatics and 95 nonasthmatic controls with Visual Analog Scale (VAS, 0-100), Sino-Nasal Outcome Test (SNOT-20), and Peak Nasal Inspiratory Flow (PNIF), respectively. Asthma and allergy status were assessed by Asthma Control Questionnaire (ACQ) and skin prick test or specific IgE.


RESULTS
Asthmatic patients (men/women, 37/54; mean age, 43.7 years; range, 19-64 years) reported significantly more nasal obstruction (mean VAS, 37 mm; SD = 26, 95% CI, 32-43 vs 9 mm, SD = 11, 95% CI, 7-11, P < .001) and lower sino-nasal quality of life (mean SNOT-20, 1.3; SD = 0.8, 95% CI, 1.1-1.5 vs 0.4, SD = 0.5, 95% CI, 0.3-0.5, P < .001) than controls (men/women, 42/53; mean age, 43.8 years; range, 20-65 years). PNIF was significantly lower in asthmatic patients than controls (mean PNIF, 84 l/min; SD = 24, 95% CI, 79-89 vs 100 l/min SD = 24, 95% CI, 95-105, P < .001).


CONCLUSIONS
Both allergic and nonallergic asthma were associated with increased sino-nasal symptoms, reduced sino-nasal QOL, and reduced inspiratory nasal air flow compared to controls. This provides further evidence of the clinical importance of the upper airway in the diagnostic and therapeutic management of asthma patients beyond the scope of allergy.
Department of Otolaryngology, Head and Neck Surgery, St Olavs Hospital, University Hospital of Trondheim, Norway. wenche.m.thorstensen@ntnu.no
Wenche Moe
WM
Thorstensen
Vegard
V
Bugten
Malcolm
M
Sue-Chu
Nils Petter Wold
NP
Fossland
Pål Richard
PR
Romundstad
Sverre Karmhus
SK
Steinsvåg
D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009668:Nose Diseases / Q000209:etiology*; D010254:Paranasal Sinus Diseases / Q000209:etiology; D011788:Quality of Life; D055815:Young Adult