title: The effect of smoking on CT score, bacterial colonization and distribution of inflammatory cells in the upper airways of patients with chronic rhinosinusitis.
abstract: OBJECTIVE
  The study was designed to determine whether smoking affects CT score, bacterial colonization of the upper airways and distribution of inflammatory cells in nasal mucosa in patients with chronic rhinosinusitis.
  
  
  METHODS
  Sixty-four patients were enrolled in the prospective study. We characterized differences in CT score, rate of revision surgery, differences in bacterial colonization in the middle nasal meatus and distribution of inflammatory cells in nasal tissue in smoking and non-smoking patients with chronic rhinosinusitis with nasal polyps (CRSwNP), chronic rhinosinusitis without nasal polyps (CRSsNP) and control group.
  
  
  RESULTS
  Direct tobacco use was associated with significantly more severe form of the disease according to the preoperative CT investigation of paranasal sinuses using Lund-Mackay scoring system in both CRSwNP (p = 0.035) and CRSsNP (p = 0.023) groups. More intense colonization of upper-respiratory tract by the pathogenic bacteria in smokers compared to non-smokers was found. Non-pathogenic bacterial flora was more often present in non-smokers compared to smokers. Plasma cells and lymphocytes were the most numerous cells in nasal tissue in all three groups. In smokers with presence of pathogenic bacteria in middle nasal meatus there was stronger neutrophil (p = 0.002) and macrophage infiltration (p = 0.044) in CRSsNP group.
  
  
  CONCLUSIONS
  Tobacco smoke exposure is related to higher Lund-Mackay score, increased colonization by pathogenic bacteria and lower incidence of commensals in middle nasal meatus, but does not influence cell distribution in nasal mucosa in patients with chronic rhinosinusitis.
authors.affiliation: Department of ENT, F.D. Roosevelt Faculty Hospital, Nam. L. Svobodu 1 , Banska Bystrica , Slovakia .
authors.forename: Barbora
authors.initials: B
authors.lastname: Uhliarova
authors.forename: Marian
authors.initials: M
authors.lastname: Adamkov
authors.forename: Martin
authors.initials: M
authors.lastname: Svec
authors.forename: Andrea
authors.initials: A
authors.lastname: Calkovska
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000276:immunology* / Q000382:microbiology; D004724:Endoscopy; D006090:Gram-Negative Bacteria / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D006094:Gram-Positive Bacteria / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity; D006785:Hospitals, University; D006801:Humans; D007113:Immunity, Innate; D008875:Middle Aged; D009296:Nasal Cavity / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology / Q000601:surgery; D009297:Nasal Mucosa / Q000000981:diagnostic imaging / Q000276:immunology* / Q000382:microbiology / Q000601:surgery; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012141:Respiratory Tract Infections / Q000276:immunology* / Q000382:microbiology; D012220:Rhinitis / Q000000981:diagnostic imaging / Q000276:immunology* / Q000382:microbiology / Q000601:surgery; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000276:immunology* / Q000382:microbiology / Q000601:surgery; D018154:Slovakia; D012907:Smoking / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014774:Virulence; D055815:Young Adult
keywords: CT score; Chronic rhinosinusitis; cigarette smoke; endoscopic sinus surgery; inflammatory cells; pathogenic bacteria