Vengathajalam, Selvamalar
(2020)
The clinical and radiological characterizations of allergic phenotype in chronic rhinosinusitis with nasal polyps.
Masters thesis, Universiti Sains Malaysia.
Abstract
Objectives: Allergic phenotype has recently been described as a subset of chronic
rhinosinusitis with polyps (CRSwNP) and without polyps (CRSsNP). Our aim is to
explain the clinical characterizations with symptoms and endoscopic Lund Kennedy
scoring as well as radiological characterizations with Lund Mackay scoring of patients
with the allergic phenotype of CRSwNP. The importance of this study is to determine
the association of allergy and CCAD to CRSwNP that will aid in further understanding
of the pathophysiology of the disease and managing the patients accordingly.
Methods: A cross-sectional studyon patients diagnosed with CRSwNP who had both
allergology and radiological assessments. Theoverall nasal symptoms score including 3
rhinologic problems, with relevance to allergy (need to blow nose, sneezing, and runny
nose), Lund Kennedy (LK) endoscopic scoring, Lund Mackay (LM) scoring of
computed tomography (CT) scan of the paranasal sinuses (PNS), central compartment
atopic disease (CCAD) features, skin prick test (SPT) and level of specific IgE were
assessed.
Results: There was no difference in overall symptoms score but there was a higher
allergy symptoms burden in atopy and CCAD groups. There was significant difference
in the endoscopic and CT PNS scores between atopy and non-atopy as well as CCAD
and non CCAD. CCAD has a significantly association with atopy and has a higher
endoscopic and CT PNS scores.
Conclusions: Atopy and its radiological phenotype, the CCAD must be properly
assessed in patients with CRSwNP as they may determine the clinical and radiological
severity. Patients with atopy and CCAD have more polypoidal involvement of the
middle turbinates, additional symptoms burden and higher endoscopic and CT PNS
scoring proving that there is an association between allergy and CRSwNP.
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