Comparison of Quality of Life and Lund Mackay Score in Subgroups of Rhinosinusitis

Abstract

Rhinosinusitis (RS) may be sub-classified into several groups based on duration of symptoms, etiology, associated clinical history, and findings during endoscopic nasal examination. While one may dissect RS into several subgroups, the four major clinical categories are Recurrent Acute Rhinosinusitis (RARS), Chronic Rhinosinusitis without Nasal Polyps (CRSsNP), Chronic Rhinosinusitis with Nasal Polyps (CRSwNP), and Hyperplastic Rhinosinusitis (HRS). The American academy of Otolaryngology defines RARS as 4 or more acute infections per year of acute bacterial rhinosinusitis [1] lasting < 12 weeks. CRS is an inflammatory condition requiring the presence of 2 or more symptoms; one of which should be nasal discharge or nasal obstruction/blockage/congestion, +/-facial pain, +/-reduced or absent sense of smell, for 12 weeks or more. In addition, endoscopic findings or CT images showing pathological changes in the middle meat us should be present. CRS may exist with Nasal Polyps (CRSwNP) or without Nasal Polyps (CRSsNP). Extensive nasal polyposis may also be driven by allergic fungal sinusitis or by aspirin sensitivity in a subset of patients with asthma and nasal polyposis (Samter's triad) [2]. The latter two groups have been collectively referred to as Hyperplastic Rhinosinusitis (HRS) by Kennedy and Borish [3], and will be referred to as such for the purposes of this study. The economic healthcare burden of RS is estimated to be in the region of $5.8 billion annually, while the Quality of Life (QoL) impact of RS is just as significant [4]. Studies have identified lower QoL scores in CRS patients compared to those with congestive heart failure, chronic back pain, and chronic obstructive pulmonary disease [5]. Furthermore, CRSwNP patients were identified as having a lighter QoL burden than CRSsNP, excluding congestion as a symptom [6].

A study on olfactory improvement assessed with butanol threshold test in chronic rhinosinusitis patients after fess at a tertiary care centre in Malabar region

“…12 In another study by Garg et al which studied 94 patients the symptom profile was similar to our study with almost 100% of subjects reporting nasal discharge and the most presenting symptom followed by facial pain and post nasal discharge. 13 The results of this study is comparable with our study in terms of symptom profile. This may be due to…”