A Prospective Cross-Sectional Study on Exhaled Nitric Oxide and Sensitivity to Indoor Inhaled Aeroallergens in Patients with Rhinosinusitis with Nasal Polyps

Background: Rhinosinusitis is a nasal and paranasal sinus infection. Chronic infection and allergies are two major causes of nasal polyp formation. Objectives: In this study, we examined the relationship between NO and aeroallergens to determine the relationship between exhaled nitric oxide level and sensitivity to aeroallergens in chronic rhinosinusitis with nasal polyps (CRSwNP) patients referring to Hazrat Rasool Hospital in Tehran from December 2016 to May 2017. Methods: A cross-sectional study was conducted on 72 patients. The prick test and exhaled NO measurements were done to determine allergens in CRSwNP patients. Statistical analysis was done to determine the relationship between the allergy and sensitivity to indoor aeroallergens in patients with CRSwNP. Results: The correlation coefficient of. 0.014 and 0.001 were evaluated for Mosquito and Cockroach respectfully, which were significantly correlated with nitric oxide. The less correlation with nitric oxide was 0.003, which was evaluated for MUCOR. Conclusions: This study showed that most people with CRSwNP had a sensitivity to at least one indoor aeroallergen, and cockroaches were the most common allergen in patients with CRSwNP with a 17.9% prevalence. This study showed that the correlation of FeNO with the sensitivity of these patients to home aeroallergens can be used, and this correlation for mosquito and cockroach aeroallergens is very valuable. The NO level and prick testing of aeroallergens can be used to estimate the relapse or lack of appropriate response to medical treatment in patients with CRSwNP.

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Occupational exposure influences control of disease in patients with chronic rhinosinusitis

Rhinology Journal ◽

10.4193/rhin21.091 ◽

2021 ◽

Vol 59 (4) ◽

pp. 380-386

Author(s):

D.A.E. Dietz de Loos ◽

S. Ronsmans ◽

M.E. Cornet ◽

P.W. Hellings ◽

V. Hox ◽

...

Keyword(s):

Occupational Exposure ◽

Chronic Rhinosinusitis ◽

Nasal Polyps ◽

Conservative Therapy ◽

Cross Sectional Study ◽

Sinus Surgery ◽

Sectional Study ◽

Cross Sectional ◽

Independent Variables ◽

The Relationship

Background: Chronic rhinosinusitis (CRS) is a frequent condition that is treated by endoscopic sinus surgery (ESS) when medical treatment fails. Irritating or sensitizing airborne agents can contribute to uncontrolled CRS. A prior study showed a linear correlation between occupational exposure and the number of ESS. Methods: In this cross-sectional study we tested the hypothesis that occupational exposure is a risk for undergoing ESS. We sent questionnaires enquiring occupational exposure in patients with CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). An expert assessed blindly the reported work exposures to inhaled agents. The relationship between occupational exposure on undergoing ESS was analysed. Results: Among all patients who underwent ESS (n=343), 30% reported a relevant occupational exposure, which is significantly higher than the 4.8% found among CRS patients that underwent no prior sinus surgery (n=21). Besides occupational exposure, self-reported doctor-diagnosed asthma were independent variables contributing to the chance of undergoing ESS. Conclusion: In our study we confirm occupational exposure as a risk factor for uncontrolled CRS, if defined by undergoing ESS. In CRS patients with uncontrolled symptoms, despite maximal conservative therapy, the clinician should explore the possible contribution of occupational exposure.

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