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. 2022 Mar;12(3):278-285.
doi: 10.1002/alr.22887. Epub 2021 Sep 12.

The association of active and passive tobacco smoke exposure with chronic rhinosinusitis symptom severity: A cross-sectional study

Jeffrey S Wolf  1 , John C Papadimitriou  2 , Robert E Morales  3 , Joseph A Califano 3rd  4 , Neila L Kline  1 , Kavita Bhatnagar  1 , Andrea M Hebert  1 , Rodney J Taylor  1
Affiliations

The association of active and passive tobacco smoke exposure with chronic rhinosinusitis symptom severity: A cross-sectional study

Jeffrey S Wolf et al. Int Forum Allergy Rhinol. 2022 Mar.

Abstract

Background: Chronic rhinosinusitis (CRS) causes a great deal of morbidity. There are a multitude of causal factors, though their precise contribution to symptom severity has yet to be defined. We hypothesized that exposure to both primary and secondhand tobacco smoke would correlate with more severe symptoms of CRS.

Methods: This is a prospective cross-sectional study performed at an academic tertiary care medical center from 2010 to 2013. A total of 85 consecutive patients with chronic sinusitis were screened; 70 with medically refractory CRS requiring functional Endoscopic sinus surgery (FESS) were enrolled. Recent tobacco exposure was assessed using serum cotinine levels. Sinonasal mucosa was biopsied to assess ciliary architecture. Demographics, medical history, tobacco and environmental exposures, and computed tomography (CT) imaging were also collected. Two quality of life (QOL) surveys were administered: one disease specific, Sinonasal Outcomes Test-20 (SNOT-20), and one general, Short Form-12 (SF-12). Results were correlated with the aforementioned exposures.

Results: The 70 patients had an average age of 46 years, and 42% were male. Variables that correlated with worse SNOT-20 scores included serum cotinine (r = 0.43, p = 0.002), number of cigarettes smoked daily (r = 0.27, p = 0.03), and number of secondhand cigarettes exposed to per day (r = 0.29, p = 0.04). There were no significant correlations between SNOT-20 scores and Lund-MacKay or axonemal ultrastructural abnormalities (AUA)-ciliary scores. The two five-variable models best predicted disease-specific QOL.

Conclusions: Increased amounts of serum cotinine and primary and secondhand smoke exposure were associated with worse sinonasal QOL. This study establishes an objective relationship between smoke exposure and patient-perceived severity of CRS, emphasizing the importance of tobacco cessation counseling as part of management.

Keywords: air pollution; biomarker; chronic rhinosinusitis; ciliary motility; computed tomography; quality of life; statistics.

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References

REFERENCES

    1. FastStats. Published February 21, 2020. Accessed March 8, 2020. https://www.cdc.gov/nchs/fastats/sinuses.htm
    1. Bhattacharyya N, Gilani S. Prevalence of potential adult chronic rhinosinusitis symptoms in the United States. Otolaryngol Neck Surg. 2018;159(3):522-525.
    1. Sedaghat AR. Chronic Rhinosinusitis. Am Fam Physician. 2017;96(8):500-506.
    1. Payne SC, Borish L, Steinke JW. Genetics and phenotyping in chronic sinusitis. J Allergy Clin Immunol. 2011;128(4):710-720.
    1. Cohen NA. Sinonasal mucociliary clearance in health and disease. Ann Otol Rhinol Laryngol. 2006;115(9):20-26. _suppl.

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