The role of upper and lower airway patency in chronic rhinosinusitis with nasal polyps and asthma

Authors

  • Zhenxiao Huang MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Bing Zhou MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
    • Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology–Head and Neck Surgery (Capital Medical University), Ministry of Education, No. 1 Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, P. R. China
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  • Qi Zhang MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Qian Huang MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Yan Sun MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Mingjie Wang MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Xiangdong Wang MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Chengshuo Wang MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Yunchuan Li MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • Shunjiu Cui MD

    1. Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital and Key Laboratory of Otolaryngology–Head and Neck Surgery, Capital Medical University, Ministry of Education, Beijing, China
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  • This study was supported by grants from the Beijing Municipal Health Bureau (No. 2009-3-36) and the National Natural Science Foundation of China (No. 30973283).

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To investigate the role of airway patency and factors associated with airway patency in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma.

Study Design:

Retrospective study.

Methods:

The upper and lower airway patency of 140 patients with CRSwNP and asthma (asthma group) and 42 patients with CRSwNP without asthma (nonasthma control group) was measured using acoustic rhinometry, rhinomanometry, and spirometry. Total serum immunoglobulin E and eosinophil counts were also compared. The severity of nasal diseases in these patients was assessed via the Lund–Mackay score (LMS) and Lund–Kennedy score (LKS).

Results:

There was no difference between the asthma and nonasthma groups in terms of total nasal resistance at 75 Pa (R75T), bilateral minimum cross-sectional area (MCAR+L), or bilateral nasal cavity volume between 0 and 7.0 cm3 (V7R+L). Forced expiratory volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25–75) of the asthma group were significantly lower than those of the nonasthma group. FEV1 and FEF25–75 were not correlated with R75T, MCAR+L, V7R+L, or severity of nasal disease. For the patients with asthma, LMS and serum eosinophil counts were independent predictors of MCAR+L.

Conclusions:

The presence of asthma may not influence upper airway patency in CRSwNP patients. In CRSwNP patients with asthma, impairment of upper airway patency was associated with changes in LMS and eosinophilia, and in these patients lower airway patency was significantly lower than that of the control group (without asthma). In CRSwNP patients with asthma, there was little or no association between upper and lower airway patency. Laryngoscope, 2013

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