Allergic sensitization does not predispose to sinus inflammation in externalized paranasal sinuses

Am J Rhinol Allergy. 2017 Jan 1;31(1):3-6. doi: 10.2500/ajra.2017.31.4388.

Abstract

Background: Chronic rhinosinusitis (CRS) has a multifactorial etiology, with a debate about the role of inhalant allergy in the pathogenesis of CRS.

Objective: This study assessed the impact of allergy status on externalized paranasal sinuses after tumor resection to determine if a predisposition to inhalant allergy brought about additional inflammation after sinus surgery.

Methodology: A case-control study was performed on patients who had no history of CRS who underwent paranasal sinus tumor resection. Allergic sensitization was defined by a positive serum ImmunoCAP test result. Outcomes were measured at least 6 months after surgery by using the modified Lund-MacKay endoscopic score and the 22-item Sino-Nasal Outcome test, with rhinitis, sleep, psychological, ear and/or facial, and sinus subscores to assess the impact of allergy status on mucosal inflammation.

Results: A total of 103 patients (53.44 ± 17.46 years; 46% women) were assessed. Of these, 61.17% were allergically sensitized at the time of surgery. Postsurgery endoscopic assessment was similar [the modified Lund-Mackay endoscopic score allergic sensitized 0.5 (1.7) versus nonallergic sensitized 0.0 (0.9); p = 0.15]. Sinonasal symptoms were also similar between the groups' 22-item Sino-Nasal Outcome test scores, allergic sensitized versus allergic nonsensitized, (allergic 28.9 ± 20.8 versus nonallergic 33.5 ± 19.7; p = 0.31), rhinitis score (5.9 ± 5.5 versus 6.4 ± 4.7; p = 0.66), sleep score (6.9 ± 5.9 versus 7.7 ± 4.8; p = 0.50), ear and/or facial symptom score (3.4 ± 3.6 versus 4.3 ± 3.3; p = 0.22), psychological score (6.9 ± 6.0 versus 8.3 ± 6.7; p = 0.29), and of nasal symptom score (6.4 ± 5.2 versus 7.0 ± 5.3; p = 0.61).

Conclusions: Externalization of the sinuses in patients with inhalant allergy did not bring about significant additional inflammation in patients after tumor surgery.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Chronic Disease
  • Comorbidity
  • Endoscopy
  • Female
  • Humans
  • Hypersensitivity / epidemiology*
  • Hypersensitivity / surgery
  • Inflammation / epidemiology*
  • Male
  • Middle Aged
  • Nose Neoplasms / epidemiology*
  • Nose Neoplasms / surgery
  • Paranasal Sinuses / immunology*
  • Paranasal Sinuses / surgery
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Rhinitis / epidemiology*
  • Rhinitis / surgery
  • Sinusitis / epidemiology*
  • Sinusitis / surgery