Rhinosinusitis without nasal polyps in COPD

Marte Rystad Øie, Sarah Bettina Dahlslett, Malcolm Sue-Chu, Anne-S Helvik, Sverre Karmhus Steinsvåg, Wenche Moe Thorstensen, Marte Rystad Øie, Sarah Bettina Dahlslett, Malcolm Sue-Chu, Anne-S Helvik, Sverre Karmhus Steinsvåg, Wenche Moe Thorstensen

Abstract

The validity of the united airway disease concept for rhinosinusitis (RS) and chronic obstructive pulmonary disease (COPD) has been questioned because of methodological limitations in previous studies. In this study we investigated the prevalence of RS without nasal polyps (RSsNP) and the severity of sinonasal symptoms in COPD and a corresponding control group. We also evaluated the diagnostic accuracy of these symptoms for RSsNP in COPD. 90 COPD patients and 93 controls were included in an observational cross-sectional study where globally accepted diagnostic criteria of RS and COPD (EPOS 2012 and GOLD) were incorporated; symptomatic and endoscopic criteria for the diagnosis of RS, and spirometry with reversibility for diagnosis of COPD. RS symptoms were identified by responses to the sinonasal outcome test (SNOT-22), nasal endoscopy identified signs of sinonasal disease and discriminated between RS with and without nasal polyps, and visual analogue scales (VAS) rated the severity of sinonasal symptoms. We found RSsNP in 51% of our COPD patients which is threefold greater than in the control group (p<0.001). Nasal discharge (72%) and nasal obstruction (62%) were the two most frequently reported symptoms in COPD. The diagnostic accuracy for RSsNP is better for the composite VAS for rhinological symptoms than for facial symptoms. We conclude that RSsNP is present in 51% of our COPD patients, which is significantly more prevalent compared to a corresponding control group. These results suggest that COPD is associated with RS.

Conflict of interest statement

Conflict of interest: M.R. Øie has nothing to disclose. Conflict of interest: S.B. Dahlslett has nothing to disclose. Conflict of interest: M. Sue-Chu has nothing to disclose. Conflict of interest: A-S. Helvik has nothing to disclose. Conflict of interest: S.K. Steinsvåg has nothing to disclose. Conflict of interest: W.M. Thorstensen has nothing to disclose.

Copyright ©ERS 2020.

Figures

FIGURE 1
FIGURE 1
Overview of the study sample showing excluded subjects in each group with positive reversibility test and nasal polyps.
FIGURE 2
FIGURE 2
a) Prevalence of symptoms of rhinosinusitis (European position paper on rhinosinusitis and nasal polyps (EPOS) criteria). Data derived from sinonasal outcome test (SNOT)-22. b) Rhinological and ear/facial SNOT subscales. Data are presented as mean±sd.
FIGURE 3
FIGURE 3
Prevalence of symptomatic and endoscopic criteria and rhinosinusitis without nasal polyps (RSsNP) in chronic obstructive pulmonary disease (COPD) and control groups.
FIGURE 4
FIGURE 4
Receiver operating characteristic curves and diagnostic accuracy of (a) composite rhinological visual analogue scale (VAS) and (b) composite facial VAS in chronic obstructive pulmonary disease (COPD) and controls for a diagnosis of rhinosinusitis without nasal polyps (RSsNP) using European position paper on rhinosinusitis and nasal polyps (EPOS) criteria. AUC: area under the curve; CI: confidence interval.

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Source: PubMed

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