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Effect of Endoscopic Sinus Surgery for Chronic Rhinosinusitis on the State of Coexisting Asthma
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A1379 - Effect of Endoscopic Sinus Surgery for Chronic Rhinosinusitis on the State of Coexisting Asthma
Author Block: T. Tajiri1, S. Fujita2, A. Toriyama1, A. Sokai1, K. Gotoh1, H. Fukada1, Y. Nakamura1, H. Kita1; 1Respiratory Medicine, Takatsuki Red Cross Hospital, Takatsuki-shi, Japan, 2Oto-Rhino-Laryngology, Takatsuki Red Cross Hospital, Takatsuki-shi, Japan.
Rationale: Coexistence of asthma and chronic rhinosinusitis (CRS) has been reported, and 40% of CRS patients have been shown to have asthma. In patients with medically refractory CRS, endoscopic sinus surgery (ESS) is indicated. Several studies have shown that ESS improved the state of coexisting asthma, such as asthma symptoms, anti-asthma medication, and pulmonary function, but not the other studies. Aim: In this retrospective study, we evaluated the effect of ESS on the state of coexisting asthma in patients with medically refractory CRS. Methods: Patients with CRS and coexisting asthma who had undergone ESS in Takatsuki Red Cross Hospital from January 2010 to December 2016 were enrolled. They were classified into two groups: eosinophilic CRS (ECRS) and non-ECRS. ECRS is defined by JESREC score (≥11) (Allergy 2015; 70: 991-1003) and the number of eosinophils in submucosa of ethmoid cavity or nasal polyps (≥70/HPF). In each group, we evaluated the frequency of asthma exacerbation during six months before and after ESS. We next evaluated the changes in anti-asthma medication and pulmonary function from baseline to six months after ESS. Results: In total, 69 patients with CRS and coexisting asthma (age, 52.1 ± 16.1 years; 35 females; 15 with aspirin intolerance) were assessed. In patients with ECRS and asthma (n = 38; age, 52.2 ± 15.5 years; 21 females), ICS dosages equivalent to fluticasone propionate were significantly decreased from baseline to six months (536.8 ± 314.9 μg vs. 398.5 ± 283.5 μg, p = 0.002). Meanwhile, in patients with non-ECRS and asthma (n = 31; age, 52.0 ± 16.9; 14 females), ICS dosages (422.6 ± 286.0 μg vs. 312.0 ± 255.5 μg, p = 0.003) and the number of controller medications (1.2 ± 0.9 vs. 0.9 ± 0.8, p = 0.05) were significantly decreased from baseline to six months. Forced expiratory volume in one second (%predicted) significantly increased from baseline to six months (97.3 ± 16.2% vs. 99.5 ± 13.6%, p = 0.03). In both groups, the frequency of asthma exacerbation was numerically decreased during six months before and after ESS, but insignificantly (p>0.10). Conclusions: In patients with CRS, ESS could have a beneficial effect on the state of coexisting asthma.
Author Block: T. Tajiri1, S. Fujita2, A. Toriyama1, A. Sokai1, K. Gotoh1, H. Fukada1, Y. Nakamura1, H. Kita1; 1Respiratory Medicine, Takatsuki Red Cross Hospital, Takatsuki-shi, Japan, 2Oto-Rhino-Laryngology, Takatsuki Red Cross Hospital, Takatsuki-shi, Japan.
Rationale: Coexistence of asthma and chronic rhinosinusitis (CRS) has been reported, and 40% of CRS patients have been shown to have asthma. In patients with medically refractory CRS, endoscopic sinus surgery (ESS) is indicated. Several studies have shown that ESS improved the state of coexisting asthma, such as asthma symptoms, anti-asthma medication, and pulmonary function, but not the other studies. Aim: In this retrospective study, we evaluated the effect of ESS on the state of coexisting asthma in patients with medically refractory CRS. Methods: Patients with CRS and coexisting asthma who had undergone ESS in Takatsuki Red Cross Hospital from January 2010 to December 2016 were enrolled. They were classified into two groups: eosinophilic CRS (ECRS) and non-ECRS. ECRS is defined by JESREC score (≥11) (Allergy 2015; 70: 991-1003) and the number of eosinophils in submucosa of ethmoid cavity or nasal polyps (≥70/HPF). In each group, we evaluated the frequency of asthma exacerbation during six months before and after ESS. We next evaluated the changes in anti-asthma medication and pulmonary function from baseline to six months after ESS. Results: In total, 69 patients with CRS and coexisting asthma (age, 52.1 ± 16.1 years; 35 females; 15 with aspirin intolerance) were assessed. In patients with ECRS and asthma (n = 38; age, 52.2 ± 15.5 years; 21 females), ICS dosages equivalent to fluticasone propionate were significantly decreased from baseline to six months (536.8 ± 314.9 μg vs. 398.5 ± 283.5 μg, p = 0.002). Meanwhile, in patients with non-ECRS and asthma (n = 31; age, 52.0 ± 16.9; 14 females), ICS dosages (422.6 ± 286.0 μg vs. 312.0 ± 255.5 μg, p = 0.003) and the number of controller medications (1.2 ± 0.9 vs. 0.9 ± 0.8, p = 0.05) were significantly decreased from baseline to six months. Forced expiratory volume in one second (%predicted) significantly increased from baseline to six months (97.3 ± 16.2% vs. 99.5 ± 13.6%, p = 0.03). In both groups, the frequency of asthma exacerbation was numerically decreased during six months before and after ESS, but insignificantly (p>0.10). Conclusions: In patients with CRS, ESS could have a beneficial effect on the state of coexisting asthma.
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