Effect of Endoscopic Sinus Surgery on Pulmonary Function of Chronic Rhinosinusitis with Asthma

Abstract

Objective: To evaluate the postoperative pulmonary function of chronic rhinosinusitis associated with nasal polyps and asthma. Method: A retrospective analysis was performed on 34 patients with/without chronic bronchial asthma who underwent ESS for medically refractory chronic rhinosinusitis with polyp. Patients received comprehensive asthma care before and after ESS (mean, 19.3 and 23.1 months, respectively). Twenty patients were not clearly diagnosed with asthma, 10 patients had mild to severe persistent aspirin-tolerant asthma, and 4 patients had moderate to severe persistent aspirin intolerant asthma. Outcomes analyzed included pre- and post-ESS individual and group mean upper airway symptom scores, Lund-Mackay CT scores, and pulmonary function test results. Results: All groups showed a significant increase in pulmonary function 1 month after ESS ( P < .01). The various index biomarker in the pulmonary function is useful for evaluating lower airway condition. V50 and V25/Ht are the most accurate reflection markers of the bronchiolar constriction. There were significant increases in the V50 and V25/Ht before and after the sinus surgery in both the AIA and ATA groups ( P < .05). ATA group is more increased of the pulmonary function than AIA group after ESS, in addition, non-asthma diagnosis group is also increased in the pulmonary function after surgery. Conclusion: Our data indicate that patients with CRS/WP compose clinically the group of bronchiolar constriction.