Endoscopic Sinus Surgery Improves Pulmonary Function in Patients with Asthma Associated with Chronic Sinusitis

Abstract

We evaluated the clinical efficacy of endonasal endoscopic sinus surgery (ESS) in patients with asthma associated with chronic sinusitis. Twenty-one patients (13 men and 8 women) from 27 to 72 years old were enrolled in this study. All patients had had sinus-related symptoms for more than 3 months and had computed tomographic evidence of paranasal sinus opacification. Fifteen patients underwent bilateral endonasal ESS under local anesthesia, and 6 other patients without surgery were controls. The sinus-related symptoms of the preoperative and postoperative periods were assessed via a questionnaire. The period 6 months prior to surgery was compared with that 6 months postoperatively with regard to peak expiratory flow and total dosage of systemic glucocorticoids. Sinus-related symptoms in the ESS group were significantly improved 6 months postoperatively. The average peak expiratory flow 6 months following surgery was improved in the ESS patients, ranging from 40 to 190 L/min. Seven patients showed a reduction in the need for corticosteroids, whereas 2 patients were unchanged and 2 patients required larger dosages. The remaining 4 patients needed no corticosteroids before or after ESS. No significant changes in sinus-related symptoms or peak expiratory flow were obtained for the control group. Improvement of paranasal sinus disease by successful ESS can alleviate pulmonary dysfunction in asthma associated with chronic sinusitis. We believe that adequate and positive treatment for chronic sinusitis would reduce not only the nasal and sinus-related symptoms evoked by chronic sinusitis, but also some of the signs induced by asthma.

A Clinical Study of Endoscopic Sinus Surgery for Sinusitis in Patients with Bronchial Asthma

“…For objective pulmonary functions after ESS, Dhong et al [25] and Manning et al [26] reported that the pulmonary function tests did not change. By contrast, Ikeda et al [27] found a significant improvement in peak expiratory flow of patients with asthma associated with chronic sinusitis following ESS, and Batra et al [28] recently found significant improvement in postoperative forced expiratory volume at 1 s and a reduction in systemic steroid usage.…”

International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

“…856 Treatment of CRS decreases the severity of asthma (Table VIII-1). 319,861,862 Using objective and subjective sinonasal and asthma outcome measures, studies have demonstrated significant clinical improvement following ESS. 320,861,[863][864][865][866] In patients with asthma and NPs, ESS was shown to improve asthma severity scores, reduce the need of inhaled corticosteroids and reduce the frequency of asthma-related emergency room visits.…”

Rapid review: sinonasal surgery vs. medical therapy for asthma in patients with chronic rhinosinusitis with or without nasal polyps

“…1). After title and abstract screening, 43 articles were retrieved for full text screening, six of which met our inclusion criteria [11][12][13][14][15][16][17][18]. Cross-reference checking did not yield any extra eligible articles.…”

“…Ikeda et al [12] performed ESS on 15 patients (mean age 47 ± 14 years, range 27-72 years) with asthma and CRS. Six patients (mean age 42 years, range 32-64 years) who did not consent to ESS served as controls and were treated with topical corticosteroids alone.…”