Correlation between Nasal Nitric Oxide and Quality‐of‐Life Improvements after Sinus Surgery

Abstract

Objectives: Analyze the correlation between preoperative nasal nitric oxide (nNO) level, its postoperative change, and symptom scores in patients with chronic rhinosinusitis (CRS). Methods: We collected pre- and postoperative 3 and 6 months nNO level for patients who received bilateral endoscopic sinus surgery. They were classified according to existence of nasal polyps (NPs) and allergy test. Subjective symptoms were provided as Sino-Nasal Outcome Test-22 (SNOT-22) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Associated medical parameters were analyzed. Results: Fifty-four patients completed the follow-up, including 16 CRS without NPs (CRSsNPs) and 38 CRS with NPs (CRSwNPs). Allergic patients had higher preoperative nNO level ( P = .042), but existence of NPs didn’t make any difference. The nNO level correlated well with computed tomography score ( P = .001), endoscopy score ( P < .001), and current smoking ( P = .038). Baseline nNO correlated with postoperative 3-month improvement in nose blowing ( P = .029) and nasal discharge ( P = .007) in CRSwNPs. In nonallergic patients, higher baseline nNO had better improvement in olfaction ( P = .039) and nasal discharge ( P = .035). Postoperative 3 month nNO change had significant correlation with improvement of olfaction only in CRSwNPs ( P = .036). The nNO change in postoperative 6 month had no correlation with any individual symptom score change in either group. Conclusions: Baseline nNO was significantly correlated to some of the symptom improvements in CRSwNPs and nonallergic group within 3 months postoperatively. Postoperative 3 month nNO change related to olfaction improvement in CRSwNPs group; however, no significant correlation could be detected in the 6-month period after surgery.