SINUSITIS AND ASTHMA - HOW DO THEY INTERRELATE IN SINUS SURGERY

Sinusitis has been suspected to be etiopathogenically linked to bronch ial asthma. Asthma, on the other hand, has been reported to affect neg atively the outcome of sinus surgery. The purpose of this study is to elucidate how sinusitis and asthma clinically interrelate, in a group of asthmatic subjects undergoing surgical interventions on the sinuses . A total of 43 asthmatic patients, selected for functional endoscopic sinus surgery, preoperatively had their sinus disease staged and thei r lung function tested and were evaluated for allergy and aspirin sens itivity. One year after surgery the surgical results were analyzed, lu ng function was re-assessed, and patients' clinical status addressed t hrough a questionnaire; and 93 nonasthmatic patients, whose functional endoscopic sinus surgery was contemporaneous, were used as a control group for the surgical results. Asthma was a critical factor negativel y affecting the outcome of sinus surgery. On the other hand, sinus dis ease extension did not correlate with asthma severity at any stage. Si nus surgery, despite being capable of improving asthma, ultimately fai led to produce significant change in lung function scores. Furthermore , consistent good surgical results on the nose did not come across as a critical issue for postoperative asthma improvement. We concluded th at, if the surgical intervention on the sinuses was found to be able c linically to benefit asthma evolution, other evidence does not seem to support a causative relationship between sinusitis and asthma. Instea d, since asthma was shown to affect sinus disease severity significant ly, their association apparently reflects a systemic inflammatory proc ess of the respiratory mucosa.