Prevalence of allergic rhinosinusitis and adenoid hypertrophy and their impact on asthma control: A tertiary care experience

Introduction: Bronchial asthma is a chronic inflammatory condition which involves dynamic airflow obstruction and presents as cough, shortness of breath, wheeze and respiratory distress. Asthma is commonly associated with allergic rhinitis and atopic dermatitis, which are together called the atopic triad. These conditions, when associated with asthma, ultimately affect the severity and the control of asthma in children. Objectives: To study the prevalence of concomitant allergic rhinosinusitis and adenoid hypertrophy in children admitted to a tertiary care hospital with childhood asthma and the association of these comorbidities with the severity of asthma. Method: Prospective observational study was conducted among 76 children with asthma. Allergic rhinosinusitis and adenoid hypertrophy were diagnosed clinically and confirmed by radiography (x-ray paranasal sinus and x-ray lateral neck). Results: The prevalence of allergic rhinosinusitis was 59.2% (45/76), and that of adenoid hypertrophy was 71% (54/76), of which Grade 3, 4 adenoid hypertrophy was seen in 47.3% (36/76) patients; 44.7% (34/76) patients had coexisting allergic rhinosinusitis and adenoid hypertrophy along with asthma. On multiple regression analysis, male gender, family history of asthma, allergic rhinosinusitis, adenoid hypertrophy and co-existence of both were found to be significantly associated with the severity of asthma. Conclusions: In individuals with childhood asthma 59.2% had allergic rhinosinusitis and 71% had adenoid hypertrophy. Additionally, male gender, family history of asthma, allergic rhinosinusitis, adenoid hypertrophy and co-existence of both were found to be significantly associated with the severity of asthma.