The link between chronic rhinosinusitis and asthma: A questionnaire-based study

Abstract

Treatments for chronic rhinosinusitis (CRS) and asthma can affect both conditions, based on the united airway concept. This study aimed to evaluate the link between CRS and asthma, based on disease-specific quality of life measures.We performed a prospective cohort study to investigate the correlations between results from CRS- and asthma-specific questionnaires. Thirty-two patients with asthma and CRS were evaluated before and after undergoing nasal surgery at a tertiary medical center.There were significant correlations between the results from the Asthma Control Test (ACT) and the Sino-Nasal Outcome Test-22, as well as between the results of the ACT and Rhinoconjunctivitis Quality of Life Questionnaire, at both the preoperative and 3-month postoperative evaluations (P < 0.01). Moreover, nasal surgery improved the sinonasal symptoms, asthma control, and pulmonary function (P < 0.01).Increasingly severe sinonasal symptoms of CRS were associated with poor asthma control. Therefore, CRS and asthma should be considered and treated as common airway diseases.

Figure 1

Patients underwent nasal surgery during nearly all months of the year. The Asthma Control Test (ACT) changes were not associated with the seasons (A), and most patients kept the same antiasthma medication over the course of the study (B). Asthma was treated according to the stepwise approach of the Global Initiative for Asthma guidelines29. Post-op = postoperative, pre-op = preoperative.

Figure 2

Patient-reported outcomes and objective clinical measurements are poorly correlated. Poor correlations were observed between the Sino-Nasal Outcome Test-22 (SNOT-22) and computed tomography (CT) scores (A), the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and CT scores (B), and the Asthma Control Test (ACT) and forced expiratory volume in 1 s (FEV₁) values (C).

Figure 3

Correlations among the preoperative and 3-month postoperative scores. There were significant preoperative (pre-op) and 3-month postoperative (post-op) correlations between the Asthma Control Test (ACT) and Sino-Nasal Outcome Test-22 (SNOT-22) values (A and C), and between the ACT and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) values (B and D).

Figure 4

Nasal surgery improved sinonasal symptoms (A and B) and asthma control (C). ACT = Asthma Control Test, post-op = postoperative, pre-op = preoperative, RQLQ = Rhinoconjunctivitis Quality of Life Questionnaire, SNOT-22 = Sino-Nasal Outcome Test-22.

Figure 5

Compared to the preoperative (pre-op) pulmonary function test results, the postoperative (post-op) forced vital capacity (FVC) (A), forced expiratory volume in 1 s (FEV₁) (B), and FEV₁/FVC ratio (C) were all significantly improved.