Treatment of chronic rhinosinusitis and its effects on asthma

¹ Tanta University Hospitals, Tanta, Egypt
² Royal National Throat, Nose and Ear Hospital, London
³ Charing Cross Hospital, London

^* To whom correspondence should be addressed. E-mail: g.scadding{at}ucl.ac.uk.

	Abstract

The effects of rhinosinusitis treatment upon asthma are disputed.

We have previously reported the first randomised prospective study of surgical compared to medical therapy of chronic rhinosinusitis in 90 patients with with and without nasal polyps. We also monitored asthma symptoms, control, FEV₁, peak flow, exhaled nitric oxide, medication use and hospitalisation at 6 and 12 months from the start of the study. This paper reports these results in 43 of those patients with concomitant asthma.

Both medical and surgical treatment of chronic rhinosinusitis were associated with subjective and objective improvements in asthma. Overall asthma control improved significantly following both treatment modalities, but was better maintained after medical therapy where improvement could also be demonstrated in the subgroup with nasal polyps. Medicine was superior to surgery with respect to eNO decrease and FEV₁ increase in the polyp patients. Two patients noted worsening of asthma post operatively.

Improvement in upper airway symptoms, as assessed by visual analogue scale, correlated with improvement in asthma symptoms and asthma control.Treatment of chronic rhinosinusitis, medical or surgical, benefits concomitant asthma; that associated with nasal polyposis benefits more from medical therapy.