title: Allergic sensitization does not predispose to sinus inflammation in externalized paranasal sinuses.
abstract: BACKGROUND
  Chronic rhinosinusitis (CRS) has a multifactorial etiology, with a debate about the role of inhalant allergy in the pathogenesis of CRS.
  
  
  OBJECTIVE
  This study assessed the impact of allergy status on externalized paranasal sinuses after tumor resection to determine if a predisposition to inhalant allergy brought about additional inflammation after sinus surgery.
  
  
  METHODS
  A case-control study was performed on patients who had no history of CRS who underwent paranasal sinus tumor resection. Allergic sensitization was defined by a positive serum ImmunoCAP test result. Outcomes were measured at least 6 months after surgery by using the modified Lund-MacKay endoscopic score and the 22-item Sino-Nasal Outcome test, with rhinitis, sleep, psychological, ear and/or facial, and sinus subscores to assess the impact of allergy status on mucosal inflammation.
  
  
  RESULTS
  A total of 103 patients (53.44 ± 17.46 years; 46% women) were assessed. Of these, 61.17% were allergically sensitized at the time of surgery. Postsurgery endoscopic assessment was similar [the modified Lund-Mackay endoscopic score allergic sensitized 0.5 (1.7) versus nonallergic sensitized 0.0 (0.9); p = 0.15]. Sinonasal symptoms were also similar between the groups' 22-item Sino-Nasal Outcome test scores, allergic sensitized versus allergic nonsensitized, (allergic 28.9 ± 20.8 versus nonallergic 33.5 ± 19.7; p = 0.31), rhinitis score (5.9 ± 5.5 versus 6.4 ± 4.7; p = 0.66), sleep score (6.9 ± 5.9 versus 7.7 ± 4.8; p = 0.50), ear and/or facial symptom score (3.4 ± 3.6 versus 4.3 ± 3.3; p = 0.22), psychological score (6.9 ± 6.0 versus 8.3 ± 6.7; p = 0.29), and of nasal symptom score (6.4 ± 5.2 versus 7.0 ± 5.3; p = 0.61).
  
  
  CONCLUSIONS
  Externalization of the sinuses in patients with inhalant allergy did not bring about significant additional inflammation in patients after tumor surgery.
authors.affiliation: Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Navid
authors.initials: N
authors.lastname: Ahmadi
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Christensen
authors.forename: Henry P
authors.initials: HP
authors.lastname: Barham
authors.forename: Gretchen M
authors.initials: GM
authors.lastname: Oakley
authors.forename: Raymond
authors.initials: R
authors.lastname: Sacks
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Harvey
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002908:Chronic Disease; D015897:Comorbidity; D004724:Endoscopy; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000601:surgery; D007249:Inflammation / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000453:epidemiology* / Q000601:surgery; D010256:Paranasal Sinuses / Q000276:immunology* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012220:Rhinitis / Q000453:epidemiology* / Q000601:surgery; D012852:Sinusitis / Q000453:epidemiology* / Q000601:surgery