Objective: To investigate the incidence and severity of pulmonary function impairment in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).
Methods: In this prospective study, fifty-six patients with bilateral CRSwNP who were scheduled for functional endoscopic sinus surgery during a period from March to June 2010 in the Department of Otolaryngology of Qilu Hospital, were recruited in this study. Routine medical and rhinological examinations such as nasal endoscopy, sinus CT scan, and skin prick tests (SPT) for common inhalant and food allergens, and cytological examination of the paraffin-embedded NP tissues were performed together with a full assessment of the pulmonary functions.
Results: Based on the pulmonary function tests, the rate of patients showing bronchial hyperresponsiveness (BHR), asthma, and abnormal pulmonery functions were 37.5%, 44.6%, and 53.6%. In patients who did not have a history of lower airway symptoms, the rate of abnormal pulmonary functions was 50.0%, the rate of BHR was 43.2%. There was an increased rate of BHR, asthma and abnormal pulmonary functions in patients with a higher polyp grading score or Lund Mackay CT scan score (polyp grading score: χ(2) were 8.077, 3.989 and 7.445, P < 0.01 or < 0.05. CT scan score: χ(2) were 3.863, 5.380 and 4.309; 4.293, 4.293 and 4.572; 10.572, 13.504 and 13.295, P < 0.01 or < 0.05). The rate of BHR and asthma in patients with positive SPT were higher (P < 0.05). In patients with eosinophils hyperplasia in nasal polyps, the rate of BHR, asthma and abnormal pulmonary functions were higher (χ(2) were 4.065, 5.217 and 3.376, P < 0.05 or P < 0.01).
Conclusions: There is a high risk of developing lower airway diseases in patients with CRSwNP.