Nasal symptomatology, obstruction, and paranasal sinus opacity in patients with chronic obstructive pulmonary disease

Čelakovský, Petr; Smatanová, Katarína; Kalfeřt, David; Pracharova, Sarka; Koblížek, Vladimír

doi:10.3109/00016489.2014.999876

Cited by 9 publications

(6 citation statements)

References 11 publications

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“…The frequency of abnormal CT findings in 21% was lower compared to the results of Kelemence et al (64%), probably due to the fact that a higher cut-off for an abnormal CT scan was used in our study (0 in Sichtelidis et al vs. > 4.26 in our study) [12]. Also Celakovsky et al found a higher rate of abnormal CTs with 38% even though they excluded patients with sino-nasal surgery, which was frequent in our cohort [15]. Also in this case they used a different cut-off compared to our study as they rated CTs to be abnormal if there was an opacity of one or more sinuses.…”

Section: Discussioncontrasting

confidence: 71%

“…5,8 In summary even though most studies indicated an association between COPD and upper airway disease such as CRS the evidence remains inconclusive and lacks a comprehensible assessment, such as sinonasal imaging or a control group. 12,14,15 To investigate the prevalence of CRS in COPD and its impact on COPD outcomes we examined symptoms of CRS in COPD patients and a control group using a structured questionnaire, SNOT-20 and computed tomography (CT) of the para-nasal sinuses. We hypothesized that the prevalence of CRS is higher in the COPD compared to the control group.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Rhinosinusitis is Frequent in Chronic Obstructive Pulmonary Disease: a Case Control Study

Steveling

Gerhards

Zaehringer³

et al. 2019

Preprint

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Background: Prevalence and impact of chronic rhinosinusitis (CRS) in chronic obstructive pulmonary disease (COPD) remain unclear. We hypothesized that CRS is more frequent in patients with COPD compared to controls and we aimed to evaluate the odds of CRS in both groups. Methods: We recruited patients with COPD and a healthy control group in a tertiary referral hospital in Switzerland. Diagnosis of CRS was defined according to published guidelines and supported by computed tomography (CT) findings. Sino-nasal-outcome-test-20 (SNOT-20) and sino-nasal-outcome-test-primary-nasal-symptom-score (SNOT-PNS-score) were self-assessed with a cut-off for abnormality of >12. Results: Data from 83 COPD patients (35 females, age: 67 years ± 10) and 34 controls (18 females, age: 67 years ± 12) were analyzed. In the COPD group 14 out of 83 (20.3%) fulfilled the diagnosis of CRS compared to only 1 out of 34 (3%) in the control group (OR 6.7; 95% CI 0.84-53.10; p = 0.064). Forty-eight COPD patients (59%) and 14 controls (41%) had an abnormal SNOT-20 score (OR 1.96; 95% CI 0.87-4.40; p=0.10), with a median score of 16.0 (ICR 21) in COPD patients compared to a median score of 8.0 (ICR 13) in controls (p=0.001). The SNOT-PNS-score was abnormal in 49 COPD patients (59%) and in 9 controls (26%) (OR 4.00; 95% CI 1.66-9.64; p=0.001). Abnormal findings of the upper airways did not correlate with COPD severity or smoking status. Conclusions: CRS was a frequent diagnosis in patients with COPD. CRS reduces quality of life in this patient group.

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Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Chronic Rhinosinusitis is Frequent in Chronic Obstructive Pulmonary Disease: a Case Control Study

Steveling

Gerhards

Zaehringer³

et al. 2019

Preprint

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“…This approach is in line with studies looking at chronic rhinosinusitis, which is defined by established criteria [27]. Cross-study comparisons are difficult due to different definitions of UAS and the use of different questionnaires [28][29][30]. Whereas the SNOT22 is a validated and commonly used questionnaire, it was not developed to screen for UAS but to assess patients for surgery in chronic rhinosinusitis.…”

Section: Discussionmentioning

confidence: 89%

Upper airway symptoms associate with the eosinophilic phenotype of COPD

et al. 2021

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BackgroundThere is growing evidence that upper airway symptoms coexist with lower airway symptoms in Chronic Obstructive Pulmonary Disease (COPD). Still, the prevalence and impact of upper airway disease on the nature and course of COPD remain unclear. We aimed to describe this in a cross-sectional study.MethodsWe examined a cohort of COPD patients with pulmonary function tests, induced sputum, blood eosinophils, atopy tests, CT of the paranasal sinuses. Lower airway symptoms were assessed using the COPD assessment test (CAT), and upper airway symptoms were assessed using the nasal subdomain of the 22-item Sino Nasal Outcome Test (SNOT22nasal). We recruited patients from five sites in Denmark and Sweden. We excluded patients with a history of asthma.FindingsIn total, 180 patients (female 55%, age 67 (±8) years, FEV1% 52.4 (±16.6), GOLD stage: A:18%, B:54%, C:3%, D:25%) were included in the study. Seventy-four patients (41%) reported high upper airway symptoms (high UAS defined as SNOT22nasal≥6) with a median score of 10 (IQR 8–13). Patients with high UAS reported higher CAT scores (17.4 (±7.5) versus 14.9 ±6.6, p<0.05) and displayed higher fractions of eosinophils in blood (median 3.0% (IQR 1.6–4.2%) versus 2.3% (IQR 1.4–3.1), p<0.05) and in induced sputum (median 1.8% (IQR 0.3–7.1%) versus median 0.5% (IQR 0–1.7%), p<0.05). No differences in atopy, CT findings or exacerbation rates were observed.ConclusionCOPD patients with upper airway disease showed increased evidence of eosinophilic disease and increased lower airway symptom burden.

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“…Apparently the sensation of nasal obstruction in asthmatics is different from controls despite being in the same PNIF group . Finally, evaluating nasal resistances by means of RM in subjects with COPD, a very recent prospective study found that these patients have higher nasal resistances compared to controls also .…”

Section: The Relation Between Nasal Flow and Patency Measurements Andmentioning

confidence: 97%

Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice

Ottaviano

Fokkens

2016

Allergy

120

111

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Objective measures can be used to assist the clinician to diagnose and treat nasal obstruction and also to quantify nasal obstruction in research. Objective measurements of nasal obstruction are as important as objective measurements of lung function. peak nasal inspiratory flow (PNIF), acoustic rhinometry (AR) and rhinomanometry (RM), with their specific peculiarity, assess different aspects of nasal obstruction. From the studies available in the literature, it seems that these methods roughly correlate with each other and that all of them can be alternatively utilized very well in research as well as in clinical practice. This review describes the various methods that can be used to measure nasal patency, airflow and resistance, mainly peak nasal inspiratory flow, rhinomanometry and acoustic rhinometry. PNIF has been demonstrated to be reproducible and as good an indication of objective nasal patency as formal rhinomanometry and has the advantage to be cheap, simple and suitable for serial measurements and for home use even in the paediatric population. PNIF normative data are available for children, adults and elderly subjects, and the availability of unilateral PNIF normal values allows evaluation of nasal sides separately. Just as in the lower airways, objective and subjective evaluation gives different information that together optimizes the diagnosis and the treatment of our patients. We argue that PNIF should be used regularly in every outpatient clinic that treats patients with nasal obstruction.

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Nasal symptomatology, obstruction, and paranasal sinus opacity in patients with chronic obstructive pulmonary disease

Cited by 9 publications

References 11 publications

Chronic Rhinosinusitis is Frequent in Chronic Obstructive Pulmonary Disease: a Case Control Study

Chronic Rhinosinusitis is Frequent in Chronic Obstructive Pulmonary Disease: a Case Control Study

Upper airway symptoms associate with the eosinophilic phenotype of COPD

Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice

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