Association between computed tomography findings and clinical symptoms in chronic rhinosinusitis with and without nasal polyps.
Objective of this study was to test whether there is a difference between chronic rhinosinusitis patients with (CRSwNP) and without (CRSsNP) nasal polyps in the association of extent of disease on CT scans with symptom severity and health-related quality-of-life (HRQL) impairment. Data sets from 271 chronic rhinosinusitis (CRS) patients who completed the Sino-Nasal Outcome Test 22 (SNOT-22) and visual analog scale (VAS) scores were subjected to principal component analysis (PCA) to identify a symptom components related to CRS. After controlling for demographics, medical therapy, and comorbidities, the association between symptom components/items excluded from PCA and Lund-Mackay score (LMS) was evaluated. No association was found between the total SNOT-22 score and LMS in CRS patients. There was an independent association between a higher "nasal" symptom component derived from SNOT-22 PCA and LMS in patients with CRSwNP (p < 0.001), but not in CRSsNP patients, with a statistically significant difference between two patient subsets (p = 0.003). In patients with CRSsNP, higher (worse) SNOT-22 "facial pain" was associated with lower LMS (p = 0.022), although the estimated change in LMS was modest. Considering VAS PCA components, higher "nasal" symptoms were associated with higher LMS in CRSwNP patients (p < 0.001) but not in CRSsNP, with a statistically significant difference between CRS groups (p = 0.024). A higher "pain" PCA component was associated with lower LMS in CRSsNP patients (p = 0.019). This study found significant differences in the relationship between symptom burden and CT scores between CRS phenotypes and no association between HRQL impairment and CT scores.
Department of Radiology, University Hospital Center "Sestre milosrdnice", Vinogradska 29, 10000, Zagreb, Croatia. tomislav_greguric@inet.hr.
Tomislav
http://orcid.org/0000-0002-3598-6784
T
Gregurić
Department of Pharmacology, Zagreb School of Medicine, Zagreb, Croatia.
Vladimir
V
Trkulja
Department of ORL/Head and Neck Surgery, Zagreb School of Medicine, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia.
Tomislav
T
Baudoin
Department of ORL/Head and Neck Surgery, Zagreb School of Medicine, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia.
Marko Velimir
MV
Grgić
Department of Orthopaedic Surgery, Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia.
Igor
I
Šmigovec
Department of ORL/Head and Neck Surgery, Zagreb School of Medicine, University Hospital Center "Sestre milosrdnice", Zagreb, Croatia.
Livije
L
Kalogjera
D000328:Adult; D002908:Chronic Disease; D005157:Facial Pain / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications / Q000000981:diagnostic imaging*; D009666:Nose / Q000000981:diagnostic imaging; D012220:Rhinitis / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
Chronic rhinosinusitis; Health-related quality of life; Principal component analysis; Sino-Nasal Outcome Test 22; Visual analog scale