Impact of Comorbid Asthma on Life Quality of Patients with Chronic Rhinosinusitis and Nasal Polyps

Pei-Wen Wu,1,2,* Po-Hung Chang,1,* Chi-Che Huang,1,2 Ta-Jen Lee,1– 3 Yu-Hsi Fan,1 Chien-Chia Huang1,2 1Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; 2School of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Otolaryngology, Xiamen Chang Gung Hospital, Xiamen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chien-Chia Huang, Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fu-Shin Street, Kweishan, Taoyuan, 333, Taiwan, Tel +886-3-3281200 ext. 8466, Fax +886-3-3979361, Email [email protected]: This study aimed to characterize the clinical features of patients with comorbid asthma and chronic rhinosinusitis with nasal polyps and to evaluate the impact of comorbid asthma on the quality of life of these patients.Methods: Adult patients with bilateral chronic rhinosinusitis with nasal polyps scheduled for sinus surgery were prospectively enrolled. Clinical information of the participants, including laboratory data and computed tomography images. The Sinonasal Outcome Test-22 was used to evaluate nasal symptoms and quality of life impairment of participants.Results: A total of 170 participants were recruited, of whom 32 (18.8%) had comorbid asthma. Compared to patients with chronic rhinosinusitis with nasal polyps and without comorbid asthma, patients with asthma exhibited significant higher age, computed tomography ethmoid/maxillary ratio, computed tomography olfactory cleft opacification score, serum total IgE, serum eosinophil cationic protein levels, and blood and tissue eosinophil count. Patients with comorbid chronic rhinosinusitis with nasal polyps and asthma exhibited significant higher total, and rhinologic- and sleep-related domains of the Sinonasal Outcome Test-22 than did those without comorbid asthma.Conclusion: Comorbid asthma is associated with more severe type 2 eosinophilic inflammation and has a significant impact on the nasal symptoms and quality of life of patients with chronic rhinosinusitis with nasal polyps, particularly as shown in the rhinologic- and sleep-related domains of the Sinonasal Outcome Test-22. This information may assist physicians in decision-making when treating these patients.Plain Language Summary: This study prospectively enrolled 170 adult patients with bilateral chronic rhinosinusitis with nasal polyps including 32 (18.8%) patients had comorbid asthma. Clinical characteristics, computed tomographic features, tissue eosinophil counts, and quality of life of participants were evaluated.Comorbid asthma is associated with more severe type 2 eosinophilic inflammation including higher computed tomographic ethmoid/maxillary ratio, olfactory cleft opacification score, serum total IgE, serum eosinophil cationic protein levels, blood eosinophil count and tissue eosinophil count, and has a significant impact on the nasal symptoms and quality of life of patients with chronic rhinosinusitis with nasal polyps, particularly as shown in the rhinologic- and sleep-related domains of the Sinonasal Outcome Test-22. This information may assist physicians in decision-making when treating these patients.Keywords: asthma, chronic rhinosinusitis with nasal polyp, quality of life, sinonasal outcome test-22, sleep dysfunction