Chronic rhinosinusitis (CRS) and asthma are related. The authors identified a gap in the literature and designed this study with a relatively large sample size of 86 patients. They included patients with comorbid asthma and CRS with or without polyps who failed medical treatment for CRS and underwent endoscopic sinus surgery (ESS). Their aim was to investigate the impact of both CRS and ESS on the quality of life of asthma patients and their asthma control. They used well-established scoring systems to quantify symptoms and findings such as Lund-McKay, Lund-Kennedy and SNOT-22. The scores were recorded preoperatively and at six months postoperatively. The authors found that approximately one half of patients with uncontrolled asthma improved after ESS. Timing of the CT scans in relation to maximum medical treatment was not mentioned. Previous ESS was performed in 50 patients, which affects the value of the Lund-McKay score. There was no sub-grouping based on systemic versus topical steroids. Antibiotic treatment was culture-based and only for 14 days. This treatment is recommended in acute exacerbations of CRS without polyps and this was not specified in the paper to be the case. EPOS considers 21 days for doxycycline or 3 months of macrolide (immune-modulation effect) when treating CRS with nasal polyps, which again was not offered to the study patients. Asthma status should be taken into consideration when treating patients with CRS. This study, however, adds to the evidence supporting the efficacy of ESS in improving asthma control.
Sinus surgery effects on asthma patients
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