title: Lung functions of Japanese patients with chronic rhinosinusitis who underwent endoscopic sinus surgery.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS), which is clinically classified into CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP), shows considerable geographic differences and heterogeneity. Eosinophilic (E) CRS with nasal polyps (ECRSwNP) has a higher degree of disease severity and higher frequency of comorbid asthma. Epidemiologic studies in different ethnic populations have improved understanding of the pathophysiology of the disease. Here we report the clinical characteristics of Japanese patients with medically refractory CRS undergoing endoscopic sinus surgery (ESS).
  
  
  METHODS
  We recruited a total of 210 CRS patients and assessed them by nasal endoscopy, the Lund-Mackay score using computed tomography (CT), peripheral eosinophilia and smoking status. We also examined the comorbidity of asthma, effects of age and lung functions in the patients.
  
  
  RESULTS
  In this study, 13% of CRSwNP patients and 20% of CRSwNP patients with peripheral blood eosinophilia exhibited obstructive lung dysfunction (FEV1/FVC <70%) despite the absence of an asthma diagnosis. Among elderly nonsmoker patients (≥ 60 years) who had never been diagnosed with asthma, 50% of CRSwNP patients with peripheral blood eosinophilia showed decreased FEV1/FVC <70%.
  
  
  CONCLUSIONS
  Our findings suggest that asthma is under-diagnosed in CRS patients who undergo ESS, especially the elderly. Although the association between CRS and asthma has been recognized, increased attention to the comorbidity of obstructive airway diseases such as asthma is still needed for management of medically refractory CRS.
authors.affiliation: Laboratory for Respiratory and Allergic Diseases, Center for Integrative Medical Sciences, The Institute of Physical and Chemical Research (RIKEN), Kanagawa, Japan; Department of Otolaryngology-Head and Neck Surgery, University of Yamanashi, Faculty of Medicine, Yamanashi, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Laboratory for Respiratory and Allergic Diseases, Center for Integrative Medical Sciences, The Institute of Physical and Chemical Research (RIKEN), Kanagawa, Japan.
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Hirota
authors.affiliation: Department of Otorhinolaryngology, Allergy Center, Saitama Medical University, Saitama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kamijo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Yamanashi, Faculty of Medicine, Yamanashi, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Yamanashi, Faculty of Medicine, Yamanashi, Japan.
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Hatsushika
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Fukui, Faculty of Medicine, Fukui, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Fujieda
authors.affiliation: Department of Otorhinolaryngology, Yokohama City University Medical Center, Kanagawa, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishitoya
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Yamanashi, Faculty of Medicine, Yamanashi, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Masuyama
authors.affiliation: Laboratory for Respiratory and Allergic Diseases, Center for Integrative Medical Sciences, The Institute of Physical and Chemical Research (RIKEN), Kanagawa, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tamari
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015897:Comorbidity; D004724:Endoscopy / Q000379:methods; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology; D009298:Nasal Polyps / Q000473:pathology / Q000601:surgery; D010256:Paranasal Sinuses / Q000473:pathology; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D012852:Sinusitis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed