title: Evaluation of airway hyperresponsiveness in chronic rhinosinusitis: values of sinus computed tomography.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) is tightly linked to airway hyperresponsiveness (AHR) and asthma. However, the practical surrogate parameters for evaluating AHR in patients with CRS remain unclear.
  
  
  OBJECTIVE
  To evaluate the diagnostic values of sinus computed tomography for AHR in patients with CRS.
  
  
  METHODS
  We performed a prospective, single-blinded study of 125 consecutive patients with CRS. These patients were subdivided into AHR and non-AHR (NAHR) groups based on histamine provocation test results. The following parameters were compared between 2 groups of CRS patients: Lund-Mackay scores, olfactory cleft (OC) scores, and serum eosinophil counts.
  
  
  RESULTS
  Fifty-seven patients (45.4%) presented with AHR. The OC scores, the ratio of OC scores to total scores, and the eosinophil counts in the AHR group were significantly higher than those in the NAHR group (P < .001). Multivariate logistic regression revealed that OC scores and eosinophil counts were independent risk factors for asymptomatic AHR (OC scores P < .001 and eosinophil counts P = .010). The OC score had a higher predictive value for AHR (area under curve, 0.800) than eosinophil counts (area under the curve, 0.637). When the OC score was 3 or higher, the sensitivity was 75.0%, specificity was 77.9%, and positive predictive value was 68.8%.
  
  
  CONCLUSIONS
  The findings validate a prospective assessment of sinus computed tomography as a screening tool for AHR in patients with CRS.
authors.affiliation: Allergy and Cancer Center, Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Fenghong
authors.initials: F
authors.lastname: Chen
authors.affiliation: Allergy and Cancer Center, Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiangqian
authors.initials: X
authors.lastname: Luo
authors.affiliation: Allergy and Cancer Center, Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Xu
authors.affiliation: Allergy and Cancer Center, Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Deng
authors.affiliation: Allergy and Cancer Center, Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Kejun
authors.initials: K
authors.lastname: Zuo
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address: allergyli@163.com.
authors.forename: Huabin
authors.initials: H
authors.lastname: Li
authors.affiliation: Allergy and Cancer Center, Otorhinolaryngology Hospital, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Electronic address: shijb@mail.sysu.edu.cn.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Shi
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000276:immunology; D016535:Bronchial Hyperreactivity / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000276:immunology; D001985:Bronchial Provocation Tests; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses; D011446:Prospective Studies; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000276:immunology; D012720:Severity of Illness Index; D016037:Single-Blind Method; D012852:Sinusitis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000276:immunology; D014057:Tomography, X-Ray Computed