Evaluation of airway hyperresponsiveness in chronic rhinosinusitis: values of sinus computed tomography.

ABSTRACT

BACKGROUND: Chronic rhinosinusitis (CRS) is tightly linked to airway hyperresponsiveness (AHR) and asthma. However, the practical surrogate parameters for evaluating AHR in patients with CRS remain unclear. OBJECTIVE: To evaluate the diagnostic values of sinus computed tomography for AHR in patients with CRS. METHODS: We performed a prospective, single-blinded study of 125 consecutive patients with CRS. These patients were subdivided into AHR and non-AHR (NAHR) groups based on histamine provocation test results. The following parameters were compared between 2 groups of CRS patients Lund-Mackay scores, olfactory cleft (OC) scores, and serum eosinophil counts. RESULTS: Fifty-seven patients (45.4%) presented with AHR. The OC scores, the ratio of OC scores to total scores, and the eosinophil counts in the AHR group were significantly higher than those in the NAHR group (P < .001). Multivariate logistic regression revealed that OC scores and eosinophil counts were independent risk factors for asymptomatic AHR (OC scores P < .001 and eosinophil counts P = .010). The OC score had a higher predictive value for AHR (area under curve, 0.800) than eosinophil counts (area under the curve, 0.637). When the OC score was 3 or higher, the sensitivity was 75.0%, specificity was 77.9%, and positive predictive value was 68.8%. CONCLUSION: The findings validate a prospective assessment of sinus computed tomography as a screening tool for AHR in patients with CRS.