Clinical Characteristics of Patients with Chronic Rhinosinusitis without Nasal Polyps in an Academic Setting

Mariel R. Benjamin, Whitney W. Stevens, Newton Li, Sumit Bose, Leslie C. Grammer, Robert C. Kern, Bruce K. Tan, David B. Conley, Stephanie S. Smith, Kevin C. Welch, Robert P. Schleimer, Anju T. Peters*

*Corresponding author for this work

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Background: Although patients with chronic rhinosinusitis without nasal polyps (CRSsNP) represent a majority of the chronic rhinosinusitis (CRS) population, they have not been completely characterized phenotypically. Objective: To perform a comprehensive phenotypic characterization of subjects with CRSsNP, using CRS with nasal polyps (CRSwNP) as a comparator. Methods: Patients with a history of CRS with positive sinus computed tomography (>18 years old) evaluated in the allergy/immunology or otolaryngology clinics of an academic center between 2002 and 2012 were identified via International Classification of Diseases, Ninth Revision codes. A retrospective chart review was performed on a subset of 507 patients with CRSsNP and 874 with CRSwNP. Characteristics analyzed included demographics, comorbid conditions, and radiologic sinus severity. Results: Of the total CRS population, approximately 82% had CRSsNP and 18% had CRSwNP. Of the 507 patients in the CRSsNP group, 319 (63%) were female compared with 393 of 847 (45%) in the CRSwNP group. The prevalence of atopy was 52% in CRSsNP versus 76% in CRSwNP (P <.0001). In CRSsNP, atopic patients had more severe radiographic disease compared with nonatopic patients (P <.005). The prevalence of asthma was 36% in CRSsNP versus 56% in CRSwNP (P <.0001). Comorbid asthma was not associated with radiographic sinus disease severity in CRSsNP but was associated with severity in CRSwNP (P <.0001). Conclusions: The relative prevalence of CRS phenotypes in the western population is approximately 80% CRSsNP and 20% CRSwNP. Patients with CRSsNP were predominantly female, whereas patients with CRSwNP were predominantly male. The prevalence of asthma was higher in our cohort of patients with CRSsNP than previously described. Atopy was associated with more severe radiographic sinonasal disease in CRSsNP, whereas asthma was not associated with radiographic sinonasal disease severity.

Original languageEnglish (US)
Pages (from-to)1010-1016
Number of pages7
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume7
Issue number3
DOIs
StatePublished - Mar 2019

Keywords

  • Allergic rhinitis
  • Asthma
  • Chronic rhinosinusitis
  • Chronic rhinosinusitis without nasal polyps
  • Nasal polyps

ASJC Scopus subject areas

  • Immunology and Allergy

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