No abstract

Sinusitis has been suspected to be etiopathogenically linked to bronchial asthma. Asthma, on the other hand, has been reported to affect negatively the outcome of sinus surgery. The purpose of this study is to elucidate how sinusitis and asthma clinically interrelate, in a group of asthmatic subjects undergoing surgical interventions on the sinuses. A total of 43 asthmatic patients, selected for functional endoscopic sinus surgery, preoperatively had their sinus disease staged and their lung function tested, and were evaluated for allergy and aspirin sensitivity. One year after surgery the surgical results were analyzed, lung function was re-assessed, and patients' clinical status addressed through a questionnaire; and 93 nonasthmatic patients, whose functional endoscopic sinus surgery was contemporaneous, were used as a control group for the surgical results. Asthma was a critical factor negatively affecting the outcome of sinus surgery. On the other hand, sinus disease extension did not correlate with asthma severity at any stage. Sinus surgery, despite being capable of improving asthma, ultimately failed to produce significant change in lung function scores. Furthermore, consistent good surgical results on the nose did not come across as a critical issue for postoperative asthma improvement. We concluded that, if the surgical intervention on the sinuses was found to be able clinically to benefit asthma evolution, other evidence does not seem to support a causative relationship between sinusitis and asthma. Instead, since asthma was shown to affect sinus disease severity significantly, their association apparently reflects a systemic inflammatory process of the respiratory mucosa.

B-2b.

No abstract

Persistent isolated inflammation ofthe sphenoid sinus, an entity that is not diagnosed velY often, pos es a challenge to clinicians and researchers alike, Its features tend to suggest that its etiopathogenesis is different fro m that of more common forms ofchronic rhinosinusitis. We report the case of a 54-y ear-old woman who had a history of distressing chronic pos tnasal drip and a globus sensation with opacification ofthesphenoid sinus. She was diagnosed with gas troesop hageal reflux, and Helicobacter pylori was detected in her gas tric contents and in the inflamed mucosa ofthe sphenoid sinus, as well. Complete sy mp tom relief was achieved only after she had undergone surgical sphenoidotomy and treatment with anti-H pylori medication. We discuss the potential fo r this ubiquitous gas tric bacterium to p lay a role in at least som eforms of chronic sinonasal inflamm ation.