CHRONIC SINUSITIS - RELATIONSHIP OF COMPUTED TOMOGRAPHIC FINDINGS TO ALLERGY, ASTHMA, AND EOSINOPHILIA

Objective.-To develop a technique for evaluating the severity of chron ic sinus disease and to examine the correlation with allergy, asthma, and eosinophilia. Design.-A survey of 104 patients undergoing surgery for chronic sinusitis. Setting.-A university hospital ear, nose, and t hroat clinic. Patients.-A referral population of adult patients being scheduled for endoscopic sinus surgery was eligible; 104 completed que stionnaires and agreed to participate. Main Outcome Measures.-Computed tomographic scans were reviewed and scored for extent of disease. Ser um samples were assayed for total IgE and specific IgE antibodies to c ommon inhalant allergens. Peripheral blood samples were analyzed for t otal eosinophil count. Surgical biopsy specimens were examined for eos inophilia and cultured for bacteria and fungi. Results.-Extensive dise ase was present in 39% of subjects and correlated well with asthma, sp ecific IgE antibodies, and eosinophilia, but not with elevated total I gE. Among patients with peripheral eosinophilia, 87% had extensive dis ease. All cultures grew aerobic bacteria; anaerobes and fungi were unc ommon. Conclusions.-We present a system for quantitation of disease ex tent using computed tomographic scans of patients with chronic sinusit is. The well-accepted associations of chronic sinusitis with asthma an d allergy appear to be restricted to the group with extensive disease. The presence of peripheral eosinophilia in patients with sinusitis in dicates a high likelihood of extensive disease.