Interrelation between Symptoms and Nasal Endoscopic Findings in the Diagnosis of Chronic Rhinosinusitis

Abstract

Objectives: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) criteria are the most commonly used criteria in the diagnosis of chronic rhinosinusitis (CRS) in Korea. Symptom-based EP3OS criteria are used in epidemiological studies, but its reliability and the best composition of criteria have not been thoroughly examined. Therefore, we aimed to verify its reliability and search the best combination of criteria to diagnose CRS in a large scale. Methods: The 2009 and 2010 data (15,445 people) on Korean National Health & Nutrition Examination Survey symptom questionnaire and nasal endoscopic findings were analyzed. EP3OS criteria composed of major and minor symptoms were used to define symptom-based CRS. Either mucopurulent rhinorrhea from middle meatus or nasal polyp was the definition of endoscopy-based CRS. The correlation between these definitions of CRS and the relative importance of symptoms, and the best combination of symptoms were analyzed. Results: The symptom-based definition of CRS showed statistically significant correlation with the endoscopy-based definition of CRS (Pearson r =0.120, P < .001). As to the correlation between symptoms and positive endoscopic finding, hyposmia or anosmia was the most correlated symptom (Pearson r = 0.134, P < .001). The most reliable symptom-based definition of CRS was +one of major symptoms + hyposmia or anosmia. Conclusions: Because the symptom-based definition didn’t show strong correlation with the endoscopy-based definition, the combination of both definitions is essential in the diagnosis of CRS. If symptom-based definition is used, one of major symptoms + hyposmia or anosmia is the most reliable criterion in the diagnosis of CRS.