Abstract
Chronic rhinosinusitis (CRS) is a common disease that substantially impairs the quality of life (QoL). Here, we aimed to assess patients’ QoL in different subtypes of CRS and correlated this with nasal polyp size to improve the clinical understanding of the burden of disease. In this retrospective single-center study, 107 patients with the following diagnoses were analyzed: CRS without nasal polyps (CRSsNP), CRS with nasal polyps (CRSwNP), or aspirin-exacerbated respiratory disease (AERD). Sino-Nasal Outcome Test-20 German Adapted Version (SNOT-20 GAV) scores and their correlation with endoscopic Total Polyp Scores (TPS) were evaluated. The mean SNOT-20 GAV scores were highest in patients with AERD (AERD = 43.4, CRSwNP = 36.3, CRSsNP = 30.9). A statistically significant correlation of total SNOT-20 GAV score with TPS was observed in CRSwNP patients (r = 0.3398, p = 0.0195), but not in AERD patients (r = 0.2341, p = 0.1407). When analyzing single SNOT-20 parameters, a strong correlation with TPS was observed for blockage/congestion of the nose, particularly in AERD patients (r = 0.65, p < 0.0001). The impact of nasal polyp size on the QoL differs amongst the subgroups of CRS. Nasal symptoms have the greatest impact on QoL in patients suffering from AERD. CRSwNP and AERD patients should be separately analyzed in clinical investigations and interpretations due to significant differences in QoL.
Highlights
Chronic Rhinosinusitis (CRS) is a common, yet complex and heterogeneous disease
Patients suffering from nasal polyposis were predominantly in the age group that ranged from 41–60 years, whereas patients with chronic rhinosinusitis in the absence of polyposis were mainly between 31 and 50 years of age (Figure 1B)
We observed that aspirin-exacerbated respiratory disease (AERD) patients have significantly higher Sino-Nasal Outcome Test-20 (SNOT-20) German adapted version (GAV) scores when compared to CRS with nasal polyps (CRSwNP) or CRSsNP
Summary
Chronic Rhinosinusitis (CRS) is a common, yet complex and heterogeneous disease. Taking into account geographic variations, the reported prevalence of CRS ranges from 4% to 16% in North American and European countries [1,2,3,4,5]. CRS is classified as primary and secondary CRS. In contrast to CRSsNP (CRS without nasal polyps), CRSwNP (CRS with nasal polyps) is associated with the type 2 inflammation endotype. Between 2.7 and 4.4% of the population are affected by CRSwNP [5]. Within those with nasal polyps, approximately 10% suffer from aspirin-exacerbated respiratory disease (AERD), a syndrome that is characterized by adult-onset asthma and hypersensitivity to non-steroidal anti-inflammatory (NSAIDs) drugs, in addition to nasal polyposis [6]. Apart from causing sino-nasal symptoms, all of the subtypes of CRS affect the sleep, mood, cognition, and productivity of patients. CRS represents a life quality impairing disease, and an enormous socioeconomic burden that causes direct and indirect health costs of up to 21.4 billion $ per year in the US alone [1]
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